Healthcare Provider Details

I. General information

NPI: 1811873813
Provider Name (Legal Business Name): ROADRUNNER HEALTH SERVICES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/14/2025
Last Update Date: 08/14/2025
Certification Date: 08/14/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3841 MIDWAY PL NE STE A
ALBUQUERQUE NM
87109-5814
US

IV. Provider business mailing address

3841 MIDWAY PL NE STE A
ALBUQUERQUE NM
87109-5814
US

V. Phone/Fax

Practice location:
  • Phone: 505-808-3754
  • Fax:
Mailing address:
  • Phone: 505-808-3754
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP2400X
TaxonomyPrison Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MR. DAVID MONTOYA
Title or Position: CEO
Credential: RN
Phone: 505-366-1184