NPI 1811000441

Susan Ann Russell, RPH

Practitioner Pharmacist San Fidel, NM

Practice location

Address: I-40, Exit 102, San Fidel, NM 87049
Phone: (505) 552-5394
Fax: (505) 552-5464
Mailing address: 804 Washington Ave, Grants, NM 87020-3025

Registered specialties

Pharmacist Primary

Pharmacy Service Providers Taxonomy 183500000X Licence 00005516 (NM)

Other Pharmacist providers in New Mexico →

Registry record

NPI: 1811000441
Entity type: Individual
Sex (as registered): Female
NPI issued: 17 Aug 2006
Record last updated: 8 Jul 2007

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.