Provider Demographics
NPI:1376975722
Name:ZAMORA, LAURA GENEVIEVE (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:LAURA
Middle Name:GENEVIEVE
Last Name:ZAMORA
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:313C MCKNIGHT AVE NE
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87102-1563
Mailing Address - Country:US
Mailing Address - Phone:575-418-5453
Mailing Address - Fax:
Practice Address - Street 1:901 N CALIFORNIA ST
Practice Address - Street 2:
Practice Address - City:SOCORRO
Practice Address - State:NM
Practice Address - Zip Code:87801-4269
Practice Address - Country:US
Practice Address - Phone:575-835-9495
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-08-07
Last Update Date:2013-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMRP00008049183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist