Individual ProviderTimothy A RodriguezPharmacistPharmacy Service ProvidersPractice Address9101 Montgomery Blvd NE, Albuquerque, NM 87111-2405(505) 275-4246PECOS EnrollmentBased on the most recent information from CMS, provider Timothy A Rodriguez 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 ID1811177090Provider TypeIndividualFull NameRodriguez, Timothy AGenderMaleSole ProprietorNoEnumeration Date11/6/2007Last Updated11/6/2007Contact InformationPractice LocationPractice Address9101 Montgomery Blvd NE, Albuquerque, NM 87111-2405Phone(505) 275-4246Fax(505) 275-4208Mailing LocationMailing Address9101 Montgomery Blvd NE, Albuquerque, NM 87111-2405Phone(505) 275-4246Fax(505) 275-4208Provider TaxonomiesCodeDescriptionLicenseCode183500000XPrimaryDescriptionPharmacistPharmacy Service ProvidersLicenseNM5360New Mexico