Healthcare Provider Details

I. General information

NPI: 1629552294
Provider Name (Legal Business Name): IRONCLAD HOME HEALTH CARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/19/2018
Last Update Date: 09/19/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

300 W HILL AVE STE A2
GALLUP NM
87301-6364
US

IV. Provider business mailing address

300 W HILL AVE STE A2
GALLUP NM
87301-6364
US

V. Phone/Fax

Practice location:
  • Phone: 480-352-1667
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State

VIII. Authorized Official

Name: VAHAN SETYAN
Title or Position: PRESIDENT
Credential:
Phone: 480-352-1667