Organization
THE UNIVERSITY OF NEW MEXICO HEALTH SCIENCES CENTER
Active
Organization
THE UNIVERSITY OF NEW MEXICO HEALTH SCIENCES CENTER
Active
Other names
New Mexico Newborn Transport
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JANELL FULLER MD (ASSOC. PROFESSOR NEWBORN TRANSPORT)
(505) 272-6409
Entity
Organization
Contact information
Practice address
MSC10 5590, 1 UNIVERSITY OF NEW MEXICO, ALBUQUERQUE, NM 87131-0001
(505) 272-2275
Mailing address
MSC10 5590, 1 UNIVERSITY OF NEW MEXICO, ALBUQUERQUE, NM 87131-0001
(505) 272-2275
Taxonomy
Speciality
Code
Description
License number
State
3416A0800X
Air Ambulance
Primary
F00025
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
642
CHAMPUS
NM
01
—
69715
PRES
NM
05
—
G2199
—
NM
01
—
NM0021R
BCBS
NM
Enumeration date
05/22/2007
Last updated
10/21/2015
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