Individual ProviderEdwin F GonzalesPharmacistPharmacy Service ProvidersPractice Address5850 Eubank Blvd NE, Albuquerque, NM 87111-6132(505) 299-7621PECOS EnrollmentBased on the most recent information from CMS, provider Edwin F Gonzales 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 ID1215243738Provider TypeIndividualFull NameGonzales, Edwin FTitleMr.CredentialRPHGenderMaleSole ProprietorYesEnumeration Date8/20/2010Last Updated8/20/2010Contact InformationPractice LocationPractice Address5850 Eubank Blvd NE, Albuquerque, NM 87111-6132Phone(505) 299-7621Fax(505) 296-8225Mailing LocationMailing Address5850 Eubank Blvd NE, Albuquerque, NM 87111-6132Phone(505) 299-7621Fax(505) 296-8225Provider TaxonomiesCodeDescriptionLicenseCode183500000XPrimaryDescriptionPharmacistPharmacy Service ProvidersLicense3486New Mexico