Provider Demographics
NPI:1679826762
Name:GUETHS, CANDIC MONET (PHARMD)
Entity type:Individual
Prefix:
First Name:CANDIC
Middle Name:MONET
Last Name:GUETHS
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1501 32ND CIR SE
Mailing Address - Street 2:
Mailing Address - City:RIO RANCHO
Mailing Address - State:NM
Mailing Address - Zip Code:87124-1913
Mailing Address - Country:US
Mailing Address - Phone:505-288-1010
Mailing Address - Fax:
Practice Address - Street 1:6565 PARADISE BLVD NW
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87114-1467
Practice Address - Country:US
Practice Address - Phone:505-288-1010
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-10-26
Last Update Date:2012-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMRP00007920183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist