Organization
BLUE HORSESHOE, INC.
Active
Other names
Advanced Home Care and Medical Supply
Organization subpart
No
Provider details
NPI number
Authorized official
TRENT NELSON BATES (ADMINISTRATOR)
(505) 627-6256
Entity
Organization
Contact information
Practice address
315 W COUNTRY CLUB RD, ROSWELL, NM 88201-5892
(505) 627-6256
Mailing address
315 W COUNTRY CLUB RD, ROSWELL, NM 88201-5892
(505) 627-6256
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
6632
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
N3288
—
NM
Enumeration date
06/22/2005
Last updated
08/21/2012
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