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Organization
VIP STARNETWORK, LLC
Active
Organization
VIP STARNETWORK, LLC
Active
Other names
VIP STARNETWORK, LLC
Organization subpart
No
Provider details
NPI number
Authorized official
JOHONNIUSS H CHEMWENO (CEO)
(505) 389-2279
Entity
Organization
Contact information
Practice address
4904 ALAMEDA BLVD NE STE B, ALBUQUERQUE, NM 87113-2385
(505) 389-2279
(505) 212-0553
Mailing address
PO BOX 90056, ALBUQUERQUE, NM 87199-0056
(505) 389-2279
(505) 212-0553
Taxonomy
Speciality
Code
Description
License number
State
251G00000X
Community Based Hospice Care Agency
—
NULL
251K00000X
Public Health or Welfare Agency
—
NULL
251X00000X
Supports Brokerage Agency
—
NULL
261QH0100X
Health Service Clinic/Center
—
NULL
261QM2500X
Medical Specialty Clinic/Center
Primary
—
NULL
Other
Enumeration date
06/19/2020
Last updated
06/19/2020
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