Healthcare Provider Details

I. General information

NPI: 1568289171
Provider Name (Legal Business Name): MM OPS ALBUQUERQUE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/24/2024
Last Update Date: 09/24/2024
Certification Date: 09/24/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5201 ROMA AVE NE
ALBUQUERQUE NM
87108-1334
US

IV. Provider business mailing address

2000 PGA BLVD STE 3230
PALM BEACH GARDENS FL
33408-2718
US

V. Phone/Fax

Practice location:
  • Phone: 505-262-2311
  • Fax:
Mailing address:
  • Phone: 561-801-4235
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number
License Number State

VIII. Authorized Official

Name: MR. ROBERT C CAMPION
Title or Position: MANAGING MEMBER
Credential:
Phone: 561-801-4235