Healthcare Provider Details

I. General information

NPI: 1063677789
Provider Name (Legal Business Name): LOMAH HEALTHCARE SERVICES, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/22/2008
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5800 KATHRYN AVE SE
ALBUQUERQUE NM
87108-4709
US

IV. Provider business mailing address

5800 KATHRYN AVE SE
ALBUQUERQUE NM
87108-4709
US

V. Phone/Fax

Practice location:
  • Phone: 505-266-2307
  • Fax: 505-265-5748
Mailing address:
  • Phone: 505-266-2307
  • Fax: 505-265-5748

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332BX2000X
TaxonomyOxygen Equipment & Supplies (DME)
License Number
License Number StateNM

VIII. Authorized Official

Name: MR. CHARLES E BARKLEY
Title or Position: PRESIDENT/CEO
Credential:
Phone: 505-266-2307