Organization
BLUE HORSESHOE, INC.
Active
Other names
Advanced Medical Supply
Organization subpart
No
Provider details
NPI number
Authorized official
JACKI GAYLE BATES (BILLING MANAGER)
(505) 623-0799
Entity
Organization
Contact information
Practice address
315 W COUNTRY CLUB RD, ROSWELL, NM 88201-5892
(505) 623-0799
(505) 627-6257
Mailing address
315 W COUNTRY CLUB RD, ROSWELL, NM 88201-5892
(505) 623-0799
(505) 627-6257
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
0604031
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
Q1543
—
NM
Enumeration date
07/17/2006
Last updated
08/22/2020
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