Healthcare Provider Details

I. General information

NPI: 1447553144
Provider Name (Legal Business Name): SIMPLISTIC MEDICAL, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/19/2010
Last Update Date: 10/09/2025
Certification Date: 10/09/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3916 CARLISLE BLVD NE STE G
ALBUQUERQUE NM
87107
US

IV. Provider business mailing address

3916 CARLISLE BLVD NE STE G
ALBUQUERQUE NM
87107-4500
US

V. Phone/Fax

Practice location:
  • Phone: 505-856-5998
  • Fax: 505-212-0099
Mailing address:
  • Phone: 505-856-5998
  • Fax: 505-212-0099

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code332BC3200X
TaxonomyCustomized Equipment (DME)
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code335E00000X
TaxonomyProsthetic/Orthotic Supplier
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State

VIII. Authorized Official

Name: JEFFREY D MILLS
Title or Position: PRESIDENT
Credential:
Phone: 505-856-5998