Provider Demographics
NPI:1508910407
Name:SCHWARTZ, LEWIS J (RPH)
Entity Type:Individual
Prefix:MR
First Name:LEWIS
Middle Name:J
Last Name:SCHWARTZ
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:#23 CR 3522
Mailing Address - Street 2:
Mailing Address - City:FLORA VISTA
Mailing Address - State:NM
Mailing Address - Zip Code:87415
Mailing Address - Country:US
Mailing Address - Phone:505-334-7215
Mailing Address - Fax:
Practice Address - Street 1:801 W MAPLE
Practice Address - Street 2:
Practice Address - City:FARMINGTON
Practice Address - State:NM
Practice Address - Zip Code:87401
Practice Address - Country:US
Practice Address - Phone:505-599-2404
Practice Address - Fax:505-599-2414
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM51281835P1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P1200XPharmacy Service ProvidersPharmacistPharmacotherapy