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General NPI Number Information
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NPI Number | 1184388589
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Entity Type | Organization
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Legal Business Name | ACT NOW DME LLC
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Dates
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Enumeration Date | 10/22/2021
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Last Update Date | 09/06/2023
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Provider Practice Location Address
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Address Line | 1930 SAN JUAN BLVD
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City | FARMINGTON
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State | NM
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Zip | 87401-2245
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Country | US
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Telephone | 505-355-1971
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Fax | 505-355-1971
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Provider Business Mailing Address
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Address Line | 7620 N HARTMAN LN STE 178
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City | TUCSON
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State | AZ
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Zip | 85743-7485
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Country | US
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Telephone | 520-354-2669
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Fax |
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Authorized Official
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Title or Position | DIRECTOR OF OPERATIONS
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Name | NICHOLAS AARON TJALAS
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Credential |
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Telephone | 520-784-3809
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332BX2000X
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Taxonomy Name | Oxygen Equipment & Supplies (DME)
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License Number |
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License Number State |
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