Basic Information
| Provider Information | |||||||||
| NPI: | 1043571920 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | ZEMENFES | ||||||||
| FirstName: | TSEHAYE | ||||||||
| MiddleName: | K | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | PHARMD | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 784 | ||||||||
| Address2: | |||||||||
| City: | MAGDALENA | ||||||||
| State: | NM | ||||||||
| PostalCode: | 878250784 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2027358215 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | MM 29 OF HIGHWAY 169 | ||||||||
| Address2: | |||||||||
| City: | ALAMO | ||||||||
| State: | NM | ||||||||
| PostalCode: | 87825 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5758542610 | ||||||||
| FaxNumber: | 5758542528 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/06/2012 | ||||||||
| LastUpdateDate: | 05/12/2021 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 04/19/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 1835P2201X | RP00008519 | NM | N | 183500000X | PH100000941 | DC | Y | Pharmacy Service Providers | Pharmacist |
No ID Information.