Provider Demographics
NPI:1205142643
Name:CHLUMSKY, TRAVIS P (PHARM D)
Entity type:Individual
Prefix:
First Name:TRAVIS
Middle Name:P
Last Name:CHLUMSKY
Suffix:
Gender:M
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1256 EL PASEO RD
Mailing Address - Street 2:
Mailing Address - City:LAS CRUCES
Mailing Address - State:NM
Mailing Address - Zip Code:88001-6026
Mailing Address - Country:US
Mailing Address - Phone:575-525-8713
Mailing Address - Fax:575-541-8561
Practice Address - Street 1:1256 EL PASEO RD
Practice Address - Street 2:
Practice Address - City:LAS CRUCES
Practice Address - State:NM
Practice Address - Zip Code:88001-6026
Practice Address - Country:US
Practice Address - Phone:575-525-8713
Practice Address - Fax:575-541-8561
Is Sole Proprietor?:No
Enumeration Date:2010-08-24
Last Update Date:2010-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMRP00007413183500000X
KSKS1-13889183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist