Provider Demographics
NPI:1376221101
Name:COCA, CARMELITA (PHARMD, PHC)
Entity Type:Individual
Prefix:DR
First Name:CARMELITA
Middle Name:
Last Name:COCA
Suffix:
Gender:F
Credentials:PHARMD, PHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2031 MUNIZ RD SW
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87105-6529
Mailing Address - Country:US
Mailing Address - Phone:505-304-2340
Mailing Address - Fax:
Practice Address - Street 1:465 SAINT MICHAELS DR STE 114
Practice Address - Street 2:
Practice Address - City:SANTA FE
Practice Address - State:NM
Practice Address - Zip Code:87505-7621
Practice Address - Country:US
Practice Address - Phone:505-913-5287
Practice Address - Fax:505-913-4949
Is Sole Proprietor?:No
Enumeration Date:2023-07-11
Last Update Date:2024-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMPC000005041835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist