Organization
INDIGENOUS INNOVATIONS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. WALTER BARBER JR. (PRINCIPAL OWNER)
(505) 686-4903
Entity
Organization
Contact information
Practice address
913 W APACHE ST, FARMINGTON, NM 87401-3899
(505) 686-4903
Mailing address
PO BOX 2885, KIRTLAND, NM 87417-2885
Taxonomy
Speciality
Code
Description
License number
State
343900000X
Non-emergency Medical Transport (VAN)
Primary
NMPRC 56258
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
70727066
—
NM
05
—
763448
—
AZ
Enumeration date
12/20/2012
Last updated
01/07/2013
Update your record
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