Organization
PURPLE COW CASE MANAGEMENT LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. RONALD NELSON TUCKER (OWNER)
(505) 623-3051
Entity
Organization
Contact information
Practice address
105 W 3RD ST, SUITE 242, ROSWELL, NM 88201-4750
(505) 623-3051
(505) 623-8095
Mailing address
105 W 3RD ST, SUITE 242, ROSWELL, NM 88201-4750
(505) 623-3051
(505) 623-8095
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
73675768
—
NM
Enumeration date
05/04/2007
Last updated
08/22/2020
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