Healthcare Provider Details

I. General information

NPI: 1811219876
Provider Name (Legal Business Name): COMPLETE MEDICAL SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/18/2010
Last Update Date: 05/26/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

109 W BLAND ST
ROSWELL NM
88203-5708
US

IV. Provider business mailing address

PO BOX 3888
ROSWELL NM
88202-3888
US

V. Phone/Fax

Practice location:
  • Phone: 575-625-2525
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QH0100X
TaxonomyHealth Service Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MIKE HURST
Title or Position: OWNER
Credential:
Phone: 575-625-2525