Healthcare Provider Details

I. General information

NPI: 1285170936
Provider Name (Legal Business Name): TOTAL MEDICAL MANAGEMENT SOLUTIONS OF NEW MEXICO LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/18/2017
Last Update Date: 01/18/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4801 LANG AVE NE STE 110
ALBUQUERQUE NM
87109-4475
US

IV. Provider business mailing address

PO BOX 31493
INDEPENDENCE OH
44131-0493
US

V. Phone/Fax

Practice location:
  • Phone: 888-863-3423
  • Fax:
Mailing address:
  • Phone: 216-571-3246
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number
License Number State

VIII. Authorized Official

Name: MS. DARLEEN LOWRIE
Title or Position: SOLE MEMBER
Credential:
Phone: 216-571-3246