Organization
ZUNI MEDICAL SUPPLY ENTERPRISE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ARLEN P. QUETAWKI (GOV./PRES. BOARD OF DIRECTORS)
(505) 782-2434
Entity
Organization
Contact information
Practice address
BUILDING 52 ROUTE 301 NORTH, ZUNI, NM 87327-0339
(505) 782-2434
(505) 782-2457
Mailing address
PO BOX 339, ZUNI, NM 87327-0339
(505) 782-2434
(505) 782-2457
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
01103
NM
332BX2000X
Oxygen Equipment & Supplies (DME)
Primary
01103
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
T1046
—
NM
Enumeration date
06/01/2005
Last updated
06/18/2012
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