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General NPI Number Information
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NPI Number | 1225170301
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Entity Type | Organization
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Legal Business Name | MER EDDY COUNTY, INC.
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Dates
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Enumeration Date | 02/13/2007
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Last Update Date | 04/10/2008
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Provider Practice Location Address
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Address Line | 1415 W AZTEC BLVD SUITE 3
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City | AZTEC
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State | NM
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Zip | 87410-1868
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Country | US
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Telephone | 505-334-4016
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Fax | 505-334-1874
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Provider Business Mailing Address
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Address Line | 1004 W PIERCE ST
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City | CARLSBAD
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State | NM
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Zip | 88220-4057
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Country | US
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Telephone | 505-885-4805
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Fax | 505-885-8833
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Authorized Official
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Title or Position | PRESIDENT & MANAGING EMPLOYEE
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Name | MRS. GENNETH ARLENE EASLEY
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Credential |
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Telephone | 505-885-4805
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 332BN1400X
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Taxonomy Name | Nursing Facility Supplies (DME)
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 332BP3500X
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Taxonomy Name | Parenteral & Enteral Nutrition Supplies (DME)
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License Number |
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License Number State |
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Taxonomy #4
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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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