# MEDISOURCE HOME HEALTH

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

## Provider details

- **NPI number:** 1639512171
- **Authorized official:** REBECCA L THOMPSON-RAMIREZ RN (ADMINISTRATOR/OWNER)
- **Authorized official phone:** (575) 910-5521

## Contact information

- **Practice address:** 406 W COLLEGE BLVD STE A, ROSWELL, NM 88201-5114
- **Practice address phone:** (575) 910-5521
- **Practice address fax:** (575) 208-1769
- **Mailing address:** 406 W COLLEGE BLVD STE A, ROSWELL, NM 88201-5114
- **Mailing address phone:** (575) 910-5521
- **Mailing address fax:** (575) 208-1769

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 251E00000X | Home Health Agency | 3434 | NM | Yes |

## Other

- **Enumeration date:** 04/15/2013
- **Last updated:** 03/17/2018