Healthcare Provider Details

I. General information

NPI: 1699365965
Provider Name (Legal Business Name): ALERACARE OF NEW MEXICO INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/21/2021
Last Update Date: 09/19/2025
Certification Date: 09/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1800 OLD PECOS TRL STE E
SANTA FE NM
87505-4759
US

IV. Provider business mailing address

5350 E HIGH ST STE 300
PHOENIX AZ
85054-5561
US

V. Phone/Fax

Practice location:
  • Phone: 888-209-8874
  • Fax:
Mailing address:
  • Phone: 888-209-8874
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QI0500X
TaxonomyInfusion Therapy Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code207QA0505X
TaxonomyAdult Medicine Physician
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code261QM1300X
TaxonomyMulti-Specialty Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: SCOTT FRIEDMAN
Title or Position: EXECUTIVE VP
Credential:
Phone: 888-209-8874