Individual ProviderShane Wilton WoolfPharmacistPharmacy Service ProvidersPractice Address8011 Harper Dr NE, Albuquerque, NM 87111-1054(505) 217-2392(505) 385-5885PECOS EnrollmentBased on the most recent information from CMS, provider Shane Wilton Woolf 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 ID1306023684Provider TypeIndividualFull NameWoolf, Shane WiltonTitleMr.CredentialPHARMDGenderMaleSole ProprietorYesEnumeration Date1/29/2008Last Updated1/29/2008Contact InformationPractice LocationPractice Address8011 Harper Dr NE, Albuquerque, NM 87111-1054Phone(505) 217-2392FaxUnlisted FaxMailing LocationMailing Address7428 Eagle Crest Ave NE, Albuquerque, NM 87113-2187Phone(505) 385-5885FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode183500000XPrimaryDescriptionPharmacistPharmacy Service ProvidersLicenseRP00006786New Mexico