IndividualActive
Alfred Baca, REGISTERED PHARMACIS
NPI 1912059304 · Pharmacist · Portales, NM
Provider details
- NPI number
- 1912059304
- Entity type
- Individual
- Primary specialty
- PharmacistPharmacy Service Providers
- Credential
- REGISTERED PHARMACIS
- Sex
- Male
- Sole proprietor
- No
- License
- 4514 (NM)
Specialties & taxonomies
Pharmacy Service Providers
Practice location
1719 S Avenue D
Portales, NM 88130-7241
Phone: (505) 356-8555
Fax: (505) 356-5659
Approximate (ZIP-level) locationGet directions
Mailing address
1663 S Roosevelt Road 4
Portales, NM 88130-9678
Registry dates
- Enumerated
- 2007-01-17
- Last updated
- 2007-07-08
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.