Organization
ROSWELL CLINIC CORP
Active
Parent organization
ROSWELL CLINIC CORP
Other names
Family Practice Wound & Ostomy Care Center
Organization subpart
Yes
Provider details
NPI number
Legal business name
ROSWELL CLINIC CORP
Authorized official
DEBBIE T. BREWER (DIRECTOR OF PROVIDER ENROLLMENT)
(877) 892-9813
Entity
Organization
Contact information
Practice address
808 N UNION AVE, SUITE B, ROSWELL, NM 88201-3921
(575) 623-5299
Mailing address
7100 COMMERCE WAY, SUITE 180, BRENTWOOD, TN 37027-2829
(866) 419-4057
(615) 465-2895
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Enumeration date
03/12/2008
Last updated
03/12/2008
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