Provider Demographics
NPI:1164831202
Name:MARTINEZ, CHRISTOPHER JAMES (PHARMD, RPH)
Entity type:Individual
Prefix:DR
First Name:CHRISTOPHER
Middle Name:JAMES
Last Name:MARTINEZ
Suffix:
Gender:M
Credentials:PHARMD, RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4950 MONTGOMERY BLVD NE
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87109-1306
Mailing Address - Country:US
Mailing Address - Phone:505-883-8706
Mailing Address - Fax:505-830-0411
Practice Address - Street 1:4950 MONTGOMERY BLVD NE
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87109-1306
Practice Address - Country:US
Practice Address - Phone:505-883-8706
Practice Address - Fax:505-830-0411
Is Sole Proprietor?:No
Enumeration Date:2014-08-02
Last Update Date:2024-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMRP00008104183500000X, 183500000X
COPHA.0020789183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NM1164831202OtherCMS
NM1164831202Medicaid