Organization
ALBUQUERQUE AMBULATORY EYE SURGERY CENTER, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. JANICE E. YOUNG (CFO)
(505) 246-2622
Entity
Organization
Contact information
Practice address
5901 HARPER DR NE, ALBUQUERQUE, NM 87109-3587
(505) 823-8545
(505) 823-8549
Mailing address
PO BOX 90550, ALBUQUERQUE, NM 87199-0550
(505) 768-1333
(505) 244-9566
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
3087
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
154528701
TEXAS MEDICAID
NM
01
—
28957512
COLORADO MEDICAID
NM
05
—
34301364
—
NM
01
—
490005505
RRB RAILROAD MEDICARE
NM
01
—
741597
ARIZONA MEDICAID
NM
01
—
NM00SS87
BCBSNM
NM
Enumeration date
06/11/2006
Last updated
01/10/2014
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