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Organization

ENCHANTMENT MEDICAL SUPPLY, LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
GODWIN ENWONGOBONG UDO JR. (OWNER)
(915) 203-8108
Entity
Organization

Contact information

Practice address
1124 S SOLANO DR, SUITE D, LAS CRUCES, NM 88001-3863
(915) 203-8108
(505) 532-5733
Mailing address
1557 MONTE VISTA AVE, LAS CRUCES, NM 88001-5731
(505) 532-5700
(505) 432-5733

Taxonomy

Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary

Other

Enumeration date
05/13/2006
Last updated
10/22/2007
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