Provider Demographics
NPI:1336749282
Name:GARCIA, MARCUS A (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:MARCUS
Middle Name:A
Last Name:GARCIA
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:500 EUBANK BLVD SE
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87123-3338
Mailing Address - Country:US
Mailing Address - Phone:505-332-6602
Mailing Address - Fax:
Practice Address - Street 1:500 EUBANK BLVD SE
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87123-3338
Practice Address - Country:US
Practice Address - Phone:505-332-6602
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-10-29
Last Update Date:2020-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMRP00009411183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NM91-1223280Medicaid