Provider Demographics
NPI:1871925867
Name:MARTINEZ, ALBERT A (RPH)
Entity type:Individual
Prefix:MR
First Name:ALBERT
Middle Name:A
Last Name:MARTINEZ
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1308 SILVER HEIGHTS BLVD
Mailing Address - Street 2:SILVER REXALL DRUG, INC.
Mailing Address - City:SILVER CITY
Mailing Address - State:NM
Mailing Address - Zip Code:88061
Mailing Address - Country:US
Mailing Address - Phone:575-388-1579
Mailing Address - Fax:575-538-0525
Practice Address - Street 1:1308 SILVER HEIGHTS BLVD
Practice Address - Street 2:SILVER REXALL DRUG, INC.
Practice Address - City:SILVER CITY
Practice Address - State:NM
Practice Address - Zip Code:88061
Practice Address - Country:US
Practice Address - Phone:575-388-1579
Practice Address - Fax:575-538-0525
Is Sole Proprietor?:No
Enumeration Date:2013-08-01
Last Update Date:2013-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMRP4495183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist