Provider Demographics
NPI:1255811451
Name:CADENA, JARON TROY
Entity type:Individual
Prefix:
First Name:JARON
Middle Name:TROY
Last Name:CADENA
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 1:1635 PALO VERDE AVE
Mailing Address - Street 2:
Mailing Address - City:LAS CRUCES
Mailing Address - State:NM
Mailing Address - Zip Code:88001-1522
Mailing Address - Country:US
Mailing Address - Phone:575-680-8500
Mailing Address - Fax:
Practice Address - Street 1:3490 NORTHRISE DR
Practice Address - Street 2:
Practice Address - City:LAS CRUCES
Practice Address - State:NM
Practice Address - Zip Code:88011-7295
Practice Address - Country:US
Practice Address - Phone:575-382-9100
Practice Address - Fax:575-382-9229
Is Sole Proprietor?:No
Enumeration Date:2018-08-16
Last Update Date:2018-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMRP00008958183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist