Healthcare Provider Details

I. General information

NPI: 1114307071
Provider Name (Legal Business Name): OWENS ADMINISTRATIVE & HEALTHCARE SUPPORT SERVICES LLC SABRINA B OWENS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/05/2015
Last Update Date: 09/02/2025
Certification Date: 08/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4300 BLAKE RD SW
ALBUQUERQUE NM
87121-5179
US

IV. Provider business mailing address

2503 METZGAR RD SW
ALBUQUERQUE NM
87105-6335
US

V. Phone/Fax

Practice location:
  • Phone: 505-243-1118
  • Fax: 505-903-5832
Mailing address:
  • Phone: 505-480-9436
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QS1000X
TaxonomyStudent Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: SABRINA OWENS
Title or Position: OWNER
Credential:
Phone: 54-809-4365