Healthcare Provider Details

I. General information

NPI: 1811345549
Provider Name (Legal Business Name): INVERSE MEDICAL, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/03/2016
Last Update Date: 01/31/2023
Certification Date: 01/31/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4904 ALAMEDA BLVD NE STE B
ALBUQUERQUE NM
87113-2385
US

IV. Provider business mailing address

PO BOX 90056
ALBUQUERQUE NM
87199-0056
US

V. Phone/Fax

Practice location:
  • Phone: 505-389-2279
  • Fax: 505-212-0553
Mailing address:
  • Phone: 505-816-8014
  • Fax: 505-212-0553

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code227800000X
TaxonomyCertified Respiratory Therapist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251V00000X
TaxonomyVoluntary or Charitable Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code251X00000X
TaxonomySupports Brokerage Agency
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License Number
License Number State
# 5
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State

VIII. Authorized Official

Name: MR. JOHONNIUSS CHEMWENO
Title or Position: CEO/PRESIDENT
Credential:
Phone: 505-816-8014