Provider Demographics
NPI:1811394406
Name:BUFFINGTON, AARON
Entity Type:Individual
Prefix:
First Name:AARON
Middle Name:
Last Name:BUFFINGTON
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3901 SONOMA SPRINGS AVE.
Mailing Address - Street 2:
Mailing Address - City:LAS CRUSES
Mailing Address - State:NM
Mailing Address - Zip Code:88011-7113
Mailing Address - Country:US
Mailing Address - Phone:505-793-2401
Mailing Address - Fax:
Practice Address - Street 1:3901 SONOMA SPRINGS AVE
Practice Address - Street 2:
Practice Address - City:LAS CRUCES
Practice Address - State:NM
Practice Address - Zip Code:88011-7105
Practice Address - Country:US
Practice Address - Phone:505-793-2401
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-11-25
Last Update Date:2014-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMRP00008193183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NMRP00008193OtherREGISTERED PHARMACIST