Provider Demographics
NPI:1417140104
Name:BARELA, ANGELA R (PHARM D)
Entity Type:Individual
Prefix:
First Name:ANGELA
Middle Name:R
Last Name:BARELA
Suffix:
Gender:F
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 1:315 N MAIN ST
Mailing Address - Street 2:
Mailing Address - City:BELEN
Mailing Address - State:NM
Mailing Address - Zip Code:87002-3715
Mailing Address - Country:US
Mailing Address - Phone:505-861-1762
Mailing Address - Fax:505-864-6998
Practice Address - Street 1:315 N MAIN ST
Practice Address - Street 2:
Practice Address - City:BELEN
Practice Address - State:NM
Practice Address - Zip Code:87002-3715
Practice Address - Country:US
Practice Address - Phone:505-861-1762
Practice Address - Fax:505-864-6998
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-25
Last Update Date:2007-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMRP00006584183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist