Provider Demographics
NPI:1598978025
Name:VARLEY, NATHAN R (PHARMD, RPH)
Entity Type:Individual
Prefix:
First Name:NATHAN
Middle Name:R
Last Name:VARLEY
Suffix:
Gender:M
Credentials:PHARMD, RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4101 INDIAN SCHOOL RD NE
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87110-3988
Mailing Address - Country:US
Mailing Address - Phone:505-232-1733
Mailing Address - Fax:505-262-7615
Practice Address - Street 1:4101 INDIAN SCHOOL RD NE
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87110-3988
Practice Address - Country:US
Practice Address - Phone:505-232-1733
Practice Address - Fax:505-262-7615
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-08
Last Update Date:2007-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMRP00006476183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist