Healthcare Provider Details
I. General information
NPI: 1558068049
Provider Name (Legal Business Name): JUST HEALTH CARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 02/14/2023
Last Update Date: 02/14/2023
Certification Date: 02/14/2023
Deactivation Date:
Reactivation Date:
III. Provider practice location address
202 MORNINGSIDE DR SE
ALBUQUERQUE NM
87108-2633
US
IV. Provider business mailing address
202 MORNINGSIDE DR SE
ALBUQUERQUE NM
87108-2633
US
V. Phone/Fax
- Phone: 505-266-0888
- Fax:
- Phone: 505-266-0888
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261QP2300X |
| Taxonomy | Primary Care Clinic/Center |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
ANDRU
ZELLER
Title or Position: OWNER
Credential: MD
Phone: 505-266-0888