David S Wildes | Albuquerque, NM • PECOS Search

David S Wildes

Pharmacist

Pharmacy Service Providers

8400 Montgomery Blvd NE, Albuquerque, NM 87111-2302

PECOS Enrollment

Based on the most recent information from CMS, provider David S Wildes does not have current enrollment records in PECOS.

Part B
Medicare Part B
Not Enrolled
HHA
Home Health Agency
Not Enrolled
DME
Durable Medical Equipment
Not Enrolled
PMD
Power Mobility Device
Not Enrolled

CMS last updated its PECOS records today at 9:43 AM.

Profile Details

Provider ID
1659503084
Provider Type
Individual
Full Name
Wildes, David S
Title
Dr.
Credential
PHARM.D.

Gender
Male
Sole Proprietor
No
Enumeration Date
8/19/2009
Last Updated
8/19/2009

Contact Information

Practice Location

8400 Montgomery Blvd NE, Albuquerque, NM 87111-2302

Unlisted Fax

Mailing Location

8400 Montgomery Blvd NE, Albuquerque, NM 87111-2302

Unlisted Fax

Provider Taxonomies

Code	Description	License
Code 183500000X Primary	Description Pharmacist Pharmacy Service Providers	License RP00007133 New Mexico