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General NPI Number Information
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NPI Number | 1518176692
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Entity Type | Organization
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Legal Business Name | THE UNIVERSITY OF NEW MEXICO HEALTH SCIENCES CENTER
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Dates
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Enumeration Date | 05/22/2007
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Last Update Date | 10/21/2015
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Provider Practice Location Address
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Address Line | MSC10 5590 1 UNIVERSITY OF NEW MEXICO
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City | ALBUQUERQUE
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State | NM
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Zip | 87131-0001
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Country | US
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Telephone | 505-272-2275
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Fax |
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Provider Business Mailing Address
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Address Line | MSC10 5590 1 UNIVERSITY OF NEW MEXICO
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City | ALBUQUERQUE
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State | NM
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Zip | 87131-0001
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Country | US
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Telephone | 505-272-2275
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Fax |
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Authorized Official
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Title or Position | ASSOC. PROFESSOR NEWBORN TRANSPORT
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Name | DR. JANELL FULLER
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Credential | MD
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Telephone | 505-272-6409
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3416A0800X
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Taxonomy Name | Air Ambulance
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License Number | F00025
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License Number State | NM
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