Healthcare Provider Details

I. General information

NPI: 1245824663
Provider Name (Legal Business Name): CHOICE HEALTH, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/25/2021
Last Update Date: 01/03/2025
Certification Date: 01/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10309 AVENIDA VISTA CERROS NW
ALBUQUERQUE NM
87114-5907
US

IV. Provider business mailing address

10309 AVENIDA VISTA CERROS NW
ALBUQUERQUE NM
87114-5907
US

V. Phone/Fax

Practice location:
  • Phone: 806-731-4000
  • Fax:
Mailing address:
  • Phone: 806-731-4000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207QH0002X
TaxonomyHospice and Palliative Medicine (Family Medicine) Physician
License Number
License Number State

VIII. Authorized Official

Name: DONALD SCOTT CALDWELL
Title or Position: CEO
Credential:
Phone: 806-731-4000