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Organization
CLOVIS BRACE SHOP
Active
Organization
CLOVIS BRACE SHOP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. CINDA J BARRINGER (MANAGER/CUSTOMER SERVICE)
(575) 762-3524
Entity
Organization
Contact information
Practice address
128 W 21ST ST, CLOVIS, NM 88101-4333
(575) 762-3524
(575) 762-3523
Mailing address
128 W 21ST ST, CLOVIS, NM 88101-4333
(575) 762-3524
(575) 762-3523
Taxonomy
Speciality
Code
Description
License number
State
332BC3200X
Customized Equipment (DME)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
76877329
—
NM
01
—
NM00TB32
BLUE CROSS BLUE SHIELD
NM
Enumeration date
01/18/2008
Last updated
01/18/2008
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