Healthcare Provider Details

I. General information

NPI: 1922696624
Provider Name (Legal Business Name): VEMG LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/07/2021
Last Update Date: 01/07/2021
Certification Date: 01/07/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1000 MARQUEZ PL APT D1
SANTA FE NM
87505-1611
US

IV. Provider business mailing address

223 N GUADALUPE ST # 218
SANTA FE NM
87501-1868
US

V. Phone/Fax

Practice location:
  • Phone: 505-339-0435
  • Fax: 505-522-8008
Mailing address:
  • Phone: 505-339-0435
  • Fax: 505-522-8008

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code246RP1900X
TaxonomyPhlebotomy Technician
License Number
License Number State

VIII. Authorized Official

Name: VIVIANELIZABETH MARQUEZDELAGARZA
Title or Position: OWNER
Credential: RPT
Phone: 505-339-0435