Provider Demographics
NPI:1174756498
Name:LUNA, ALBERT JAMES (RPH)
Entity type:Individual
Prefix:
First Name:ALBERT
Middle Name:JAMES
Last Name:LUNA
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2101 NORTHERN BLVD NE
Mailing Address - Street 2:
Mailing Address - City:RIO RANCHO
Mailing Address - State:NM
Mailing Address - Zip Code:87124-4727
Mailing Address - Country:US
Mailing Address - Phone:505-217-3980
Mailing Address - Fax:505-217-3986
Practice Address - Street 1:2101 NORTHERN BLVD NE
Practice Address - Street 2:
Practice Address - City:RIO RANCHO
Practice Address - State:NM
Practice Address - Zip Code:87124-4727
Practice Address - Country:US
Practice Address - Phone:505-217-3980
Practice Address - Fax:505-217-3986
Is Sole Proprietor?:Yes
Enumeration Date:2009-09-02
Last Update Date:2012-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMRP00006148183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist