# PINON HEALTHCARE, LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1003464652
- **Authorized official:** DIKILYN TYSON (OWNER)
- **Authorized official phone:** (505) 860-5180

## Contact information

- **Practice address:** 904 E 20TH ST STE B, FARMINGTON, NM 87401-4281
- **Practice address phone:** (505) 787-2680
- **Practice address fax:** (505) 787-2668
- **Mailing address:** PO BOX 166, FARMINGTON, NM 87499-0166
- **Mailing address phone:** (505) 787-2680
- **Mailing address fax:** (505) 787-2668

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207QS1201X | Sleep Medicine (Family Medicine) Physician | — | — | Yes |

## Other

- **Enumeration date:** 08/27/2019
- **Last updated:** 08/27/2019

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 0000000000000 | IN PROGRESS | — |