Individual ProviderJeremy MaPharmacistPharmacy Service ProvidersPractice Address8011 Harper Dr NE, Albuquerque, NM 87111-1054(505) 858-3134(505) 507-4094PECOS EnrollmentBased on the most recent information from CMS, provider Jeremy Ma 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 ID1124543749Provider TypeIndividualFull NameMa, JeremyCredentialRPHGenderMaleSole ProprietorNoEnumeration Date8/4/2017Last Updated8/4/2017Contact InformationPractice LocationPractice Address8011 Harper Dr NE, Albuquerque, NM 87111-1054Phone(505) 858-3134FaxUnlisted FaxMailing LocationMailing Address1412 Montiano Loop SE, Rio Rancho, NM 87124-8770Phone(505) 507-4094FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode183500000XPrimaryDescriptionPharmacistPharmacy Service ProvidersLicenseRP00008771New Mexico