Healthcare Provider Details

I. General information

NPI: 1801872981
Provider Name (Legal Business Name): TURQUOISE, LTD.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/20/2005
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

734 N RIVERSIDE DR SUITE C
ESPANOLA NM
87532-2957
US

IV. Provider business mailing address

PO BOX 2407
SHERMAN TX
75091-2407
US

V. Phone/Fax

Practice location:
  • Phone: 505-753-2795
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State

VIII. Authorized Official

Name: JOHN STOGNER
Title or Position: CFO
Credential:
Phone: 903-893-0677