Individual ProviderNathan VasquezPharmacistPharmacy Service ProvidersPractice Address8510 Montgomery Blvd NE, Albuquerque, NM 87111-2307(505) 348-0066PECOS EnrollmentBased on the most recent information from CMS, provider Nathan Vasquez does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records today at 9:43 AM.Profile DetailsProvider ID1114708021Provider TypeIndividualFull NameVasquez, NathanGenderMaleSole ProprietorYesEnumeration Date10/9/2023Last Updated10/9/2023Contact InformationPractice LocationPractice Address8510 Montgomery Blvd NE, Albuquerque, NM 87111-2307Phone(505) 348-0066FaxUnlisted FaxMailing LocationMailing Address5082 Kenwood Rd, Las Cruces, NM 88012-7426PhoneUnlisted PhoneFaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode183500000XPrimaryDescriptionPharmacistPharmacy Service ProvidersLicenseRP00010015New Mexico