Organization
PNEUMEXICO RESPIRATORY, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MATT IAN TRUJILLO CRT, RCP (PRESIDENT / RESPIRATORY THERAPIST)
(505) 898-8808
Entity
Organization
Contact information
Practice address
102 MOUNTAIN PARK PL NW, SUITE A, ALBUQUERQUE, NM 87114-2290
(505) 898-8808
(505) 898-3479
Mailing address
102 MOUNTAIN PARK PL NW, SUITE A, ALBUQUERQUE, NM 87114-2290
(505) 898-8808
(505) 898-3479
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
FA0052168
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
09887253
—
NM
01
—
1025700
ACM / UNITED HEALTHCARE
NM
01
—
NM00TA32
BLUE CROSS / BLUE SHEILD
NM
Enumeration date
04/19/2006
Last updated
08/22/2020
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