Healthcare Provider Details

I. General information

NPI: 1649894544
Provider Name (Legal Business Name): HOPE MEDICAL SERVICES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/05/2020
Last Update Date: 06/05/2020
Certification Date: 06/05/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

305 FACULTY LN
CORRALES NM
87048-8721
US

IV. Provider business mailing address

305 FACULTY LN
CORRALES NM
87048-8721
US

V. Phone/Fax

Practice location:
  • Phone: 505-228-5178
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DAVID LEE HEMPHILL
Title or Position: OWNER OF PRACTICE
Credential: MD
Phone: 505-228-5178