Healthcare Provider Details

I. General information

NPI: 1922044189
Provider Name (Legal Business Name): NOR-LEA HOSPITAL DISTRICT
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/22/2006
Last Update Date: 01/11/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2827 N. DAL PASO SUITE 117
HOBBS NM
88240-2062
US

IV. Provider business mailing address

1600 NORTH MAIN
LOVINGTON NM
88260-2813
US

V. Phone/Fax

Practice location:
  • Phone: 575-392-6314
  • Fax: 575-392-8182
Mailing address:
  • Phone: 575-396-6611
  • Fax: 575-396-0318

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number6204A2
License Number StateNM

VIII. Authorized Official

Name: DAVID B SHAW
Title or Position: CEO/ADMINISTRATION
Credential:
Phone: 575-396-6611