Healthcare Provider Details

I. General information

NPI: 1043360332
Provider Name (Legal Business Name): BMVENN INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/11/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

530 W CORDOVA RD SUITE E
SANTA FE NM
87505-1844
US

IV. Provider business mailing address

530 W CORDOVA RD SUITE E
SANTA FE NM
87505-1844
US

V. Phone/Fax

Practice location:
  • Phone: 505-988-1977
  • Fax: 505-988-1961
Mailing address:
  • Phone: 505-988-1977
  • Fax: 505-988-1961

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332BC3200X
TaxonomyCustomized Equipment (DME)
License Number
License Number State

VIII. Authorized Official

Name: MISS BARBARA M VENN
Title or Position: OWNER
Credential: C.PED
Phone: 505-988-1977