DR. CHARLES EDWARD MAHAN III (NPI# 1366522666) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1366522666 |
| Entity Type | Individual |
| Full Name | DR. CHARLES EDWARD MAHAN III |
| Credential | PHARMD, PHC, RPH |
| Practice Address |
601 Dr Martin Luther King Jr Ave Ne Albuquerque NM 87102-3619 |
| Mailing Address |
13215 Russian Sage Ct Ne Albuquerque NM 87111-8270 |
| Practice Telephone | 5057278877 |
| Practice Fax Number | 5057279269 |
| Mailing Telephone | 5058210383 |
| Enumeration Date | 2006-10-17 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1835P1200X |
Pharmacist Specialization: Pharmacotherapy |
RP6003, PC107 | NM | Pharmacy Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730514225 | Charles Samuel Mahan | Obstetrics & Gynecology | 3111 E. Fletcher Av., Tampa, FL 33611 | 2013-09-04 |
| 1659529964 | Charles Keith Mahan | Military Health Care Provider | 2600 Tarawa Ct, Norfolk, VA 23521-3235 | 2008-08-29 |
| 1235226507 | Charles Scott Mahan | Internal Medicine | 11100 Euclid Ave, Cleveland, OH 44106-1716 | 2006-10-06 |
| Street Address |
601 DR MARTIN LUTHER KING JR AVE NE |
| City | ALBUQUERQUE |
| State | NM |
| Zip Code | 87102-3619 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649261611 | Gilbert M Martinez | Nuclear Medicine | 601 Dr Martin Luther King Jr Ave Ne, Albuquerque, NM 87102-3619 | 2005-10-31 |
| 1114533239 | Mattie Firlit | Dietitian, Registered | 601 Dr Martin Luther King Jr Ave Ne, Albuquerque, NM 87102-3619 | 2020-09-23 |
| 1184263303 | Seth Tyler Gambone | Nurse Anesthetist, Certified Registered | 601 Dr Martin Luther King Jr Ave Ne, Albuquerque, NM 87102-3619 | 2020-01-06 |
| 1518527530 | Shannon Erickson | Dietitian, Registered | 601 Dr Martin Luther King Jr Ave Ne, Albuquerque, NM 87102-3619 | 2019-06-20 |
| 1396218095 | Caroline Jane Spencer | Dietitian, Registered | 601 Dr Martin Luther King Jr Ave Ne, Albuquerque, NM 87102-3619 | 2019-01-04 |
| 1023596491 | Jason Michael Rotonda | Registered Nurse | 601 Dr Martin Luther King Jr Ave Ne, Albuquerque, NM 87102 | 2018-07-30 |
| 1275010985 | Main Street Anesthesia of New Mexico, LLC | Anesthesiology | 601 Dr Martin Luther King Jr Ave Ne, Albuquerque, NM 87102-3619 | 2018-07-25 |
| 1740779560 | Paris Arlette Cook | Pharmacist | 601 Dr Martin Luther King Jr Ave Ne, Albuquerque, NM 87102-3619 | 2018-05-07 |
| 1386150076 | Raiza Stephanie Mena | Registered Nurse | 601 Dr Martin Luther King Jr Ave Ne, Albuquerque, NM 87102-3619 | 2017-12-18 |
| 1255843710 | Bernadette Perea-zamora | Registered Nurse | 601 Dr Martin Luther King Jr Ave Ne, Albuquerque, NM 87102-3619 | 2017-10-24 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407454937 | Julie Wood | Acupuncturist | 1600 Luna Circle Nw, Albuquerque, NM 87102 | 2020-10-16 |
| 1770121410 | Emily Perez | Counselor | 218 Broadway Ne, Albuquerque, NM 87102 | 2019-12-12 |
| 1417503392 | Tess Holtry | Behavior Technician | 1424 Walter St Nw, Albuquerque, NM 87102 | 2019-08-15 |
| 1942867486 | Christy E Cheromiah | Behavioral Analyst | Open Skies Helathcare, 707 Broadway Blvd Ne, Albuquerque, NM 87102 | 2019-05-21 |
| 1730744103 | Faith Petra Maxwell | Behavior Technician | 900 Arno St, Albuquerque, NM 87102 | 2019-05-01 |
| 1568923761 | Storm Swinford | Behavioral Analyst | Open Skies Healthcare, 707 Broadway Blvd Ne, Albuquerque, NM 87102 | 2019-03-29 |
| 1093276651 | Tina Marie Trujillo | Behavioral Analyst | Open Skies Health Care, 707 Broadway Blvd Ne, Albuquerque, NM 87102 | 2019-03-27 |
| 1861950370 | Meghan Montoya | Student in an Organized Health Care Education/Training Program | 801 Camino De Salud, Albuquerque, NM 87102 | 2019-03-05 |
| 1174099329 | Dilshani N Tyson | Counselor | 600 1st Street Nw Ste 200, Albuquerque, NM 87102 | 2018-10-15 |
| 1962987925 | Tania L Goldfeder | Social Worker | New Mexico Solutions, 707 Broadway Ne Suite 500, Albuquerque, NM 87102 | 2018-09-26 |
| Find all providers in zip 87102 | ||||
| Taxonomy Code | 1835P1200X |
| Grouping | Pharmacy Service Providers |
| Classification | Pharmacist |
| Specialization | Pharmacotherapy |
| A licensed pharmacist who has demonstrated specialized knowledge and skill in optimizing pharmacotherapeutic care of patients, by developing, implementing, monitoring, and modifying complex treatment plans, providing advanced level education and consultation, and collaborating with other health professionals in the management of therapy. |
| Notes: Source: Specialty certification and recertification program administered by Board of Pharmaceutical Specialties, www.bpsweb.org [7/1/2006: modified definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750798575 | Rebecca Van Vleck | Pharmacist | 12501 Monarch Dr Ne, Albuquerque, NM 87123-1542 | 2014-07-14 |
| 1962751834 | James J Nawarskas | Pharmacist | 1101 Medical Arts, N.e., Bldg. 4 - Suite A, Albuquerque, NM 87106 | 2012-09-06 |
| 1750614178 | Paul D Gailard | Pharmacist | 5019 San Adan Ave Nw, Albuquerque, NM 87120-1835 | 2009-09-16 |
| 1346422458 | David B Denoyer | Pharmacist | 7417 Staghorn Dr Nw, Albuquerque, NM 87120-3019 | 2007-11-30 |
| 1891919858 | Renee-claude Mercier | Pharmacist | University of New Mexico College of Pharmacy, Msc09 5360 1 University of New Mexico, Albuquerque, NM 87131-0001 | 2007-04-12 |
| 1902828965 | Melanie A. Dodd | Pharmacist | 1101 Medical Arts Ave Ne Bldg 4, Unm Senior Health Center, Albuquerque, NM 87102-2706 | 2006-07-25 |
| 1689646580 | Norm Smith | Pharmacist | Box 26672, Albuquerque, NM 87125-6672 | 2006-02-03 |
| 1275524910 | Justina M Vigil | Pharmacist | 1501 San Pedro Dr Se Dept 119, Albuquerque, NM 87108-5153 | 2005-11-02 |
| 1285623629 | Joe R Anderson | Pharmacist | 2502 Marble Ne, College of Pharmacy, Albuquerque, NM 87131-0001 | 2005-10-18 |
| 1619964293 | Pamela Walton Mccoy | Pharmacist | 1501 San Pedro Dr Se, Albuquerque, NM 87108-5153 | 2005-09-29 |
| Find all providers in ALBUQUERQUE | ||||
| City | ALBUQUERQUE |
| Zip Code | 87102 |
Please comment or provide details below to improve the information on DR. CHARLES EDWARD MAHAN III.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.