Provider Demographics
NPI:1326261397
Name:JAUREQUI, JOSEPH PATRICK (PHARM D)
Entity Type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:PATRICK
Last Name:JAUREQUI
Suffix:
Gender:M
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:605 E 34TH ST
Mailing Address - Street 2:
Mailing Address - City:SILVER CITY
Mailing Address - State:NM
Mailing Address - Zip Code:88061-7254
Mailing Address - Country:US
Mailing Address - Phone:505-538-5720
Mailing Address - Fax:
Practice Address - Street 1:100 CALLE EL CENTRO
Practice Address - Street 2:
Practice Address - City:FORT BAYARD
Practice Address - State:NM
Practice Address - Zip Code:88036
Practice Address - Country:US
Practice Address - Phone:505-537-8749
Practice Address - Fax:505-537-8897
Is Sole Proprietor?:No
Enumeration Date:2007-04-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMRP00006625183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist