Provider Demographics
NPI:1518301852
Name:PRIETO, MARITA (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:MARITA
Middle Name:
Last Name:PRIETO
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 1:131 MARKET ST
Mailing Address - Street 2:
Mailing Address - City:ALAMOSA
Mailing Address - State:CO
Mailing Address - Zip Code:81101-2238
Mailing Address - Country:US
Mailing Address - Phone:719-589-6656
Mailing Address - Fax:719-589-0994
Practice Address - Street 1:131 MARKET ST
Practice Address - Street 2:
Practice Address - City:ALAMOSA
Practice Address - State:CO
Practice Address - Zip Code:81101-2238
Practice Address - Country:US
Practice Address - Phone:719-589-6656
Practice Address - Fax:719-589-0994
Is Sole Proprietor?:No
Enumeration Date:2013-04-17
Last Update Date:2021-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO18495183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist