Healthcare Provider Details

I. General information

NPI: 1548155302
Provider Name (Legal Business Name): ROADRUNNER FOOD BANK OF NEW MEXICO, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/11/2025
Last Update Date: 07/01/2025
Certification Date: 07/01/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5840 OFFICE BLVD NE
ALBUQUERQUE NM
87109-5819
US

IV. Provider business mailing address

5840 OFFICE BLVD NE
ALBUQUERQUE NM
87109-5819
US

V. Phone/Fax

Practice location:
  • Phone: 505-247-2052
  • Fax:
Mailing address:
  • Phone: 505-247-2052
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code172V00000X
TaxonomyCommunity Health Worker
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code177F00000X
TaxonomyLodging Provider
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code174200000X
TaxonomyMeals Provider
License Number
License Number State

VIII. Authorized Official

Name: KATY ANDERSON
Title or Position: VP STRATEGY, PARTNERSHIPS, ADVOCACY
Credential:
Phone: 505-349-5344