Organization
SPROCKET MEDICAL MANAGEMENT LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. DEBBIE BREWER (PROVIDER ENROLLMENT DIRECTOR)
(877) 892-9813
Entity
Organization
Contact information
Practice address
5419 N LOVINGTON HWY, HOBBS, NM 88240-9100
(505) 491-5000
Mailing address
5419 N LOVINGTON HWY, HOBBS, NM 88240-9100
(505) 491-5000
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
—
—
208D00000X
General Practice Physician
Primary
—
—
367500000X
Certified Registered Nurse Anesthetist
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
70437238
—
NM
01
—
NM007E98
BCBS
NM
Enumeration date
04/07/2006
Last updated
03/11/2008
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