Provider Demographics
NPI:1861852808
Name:CHI, REGINA (PHARM D)
Entity Type:Individual
Prefix:
First Name:REGINA
Middle Name:
Last Name:CHI
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:
Other - First Name:REGINA
Other - Middle Name:CHILUM
Other - Last Name:AMBE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PHARM D
Mailing Address - Street 1:1820 UNSER BLVD NW
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87120
Mailing Address - Country:US
Mailing Address - Phone:505-600-4292
Mailing Address - Fax:505-600-4291
Practice Address - Street 1:1820 UNSER BLVD NW
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87120
Practice Address - Country:US
Practice Address - Phone:505-600-4292
Practice Address - Fax:505-600-4291
Is Sole Proprietor?:No
Enumeration Date:2016-03-03
Last Update Date:2016-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMRP00008374183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist