Provider Demographics
NPI:1942596309
Name:ROJO, VICTORIA BETH (RPH)
Entity Type:Individual
Prefix:
First Name:VICTORIA
Middle Name:BETH
Last Name:ROJO
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7404 EL MORRO RD NE
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87109-3804
Mailing Address - Country:US
Mailing Address - Phone:505-899-4623
Mailing Address - Fax:
Practice Address - Street 1:8100 WYOMING BLVD NE
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87113-1946
Practice Address - Country:US
Practice Address - Phone:505-857-9783
Practice Address - Fax:505-857-9783
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-23
Last Update Date:2012-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMRP00006087183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist