Organization
STATE OF NEW MEXICO DEPT. OF FINANCE AND ADMINISTRATIVE CENT PAYROLL
Active
Other names
DOH DDSD CSB Specialty Seating Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
JENNIFER KAY THORNE-LEHMAN (DEPUTY DIRECTOR, DOH)
(505) 827-2503
Entity
Organization
Contact information
Practice address
7905 MARBLE AVE NE, ALBUQUERQUE, NM 87110-7886
(505) 232-5726
(505) 232-5724
Mailing address
7905 MARBLE AVE NE, ALBUQUERQUE, NM 87110-7886
(505) 232-5726
(505) 232-5724
Taxonomy
Speciality
Code
Description
License number
State
332BC3200X
Customized Equipment (DME)
Primary
03-069100-00-1
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
Q2441
—
NM
Enumeration date
12/18/2006
Last updated
05/10/2018
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