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General NPI Number Information
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NPI Number | 1669710034
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Entity Type | Organization
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Legal Business Name | ENMU ROSWELL
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Dates
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Enumeration Date | 01/19/2013
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Last Update Date | 01/19/2013
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Provider Practice Location Address
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Address Line | 701 E COUNTRY CLUB RD
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City | ROSWELL
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State | NM
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Zip | 88201-7607
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Country | US
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Telephone | 575-627-2808
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Fax | 575-624-7100
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Provider Business Mailing Address
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Address Line | PO BOX 6000
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City | ROSWELL
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State | NM
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Zip | 88202-6000
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Country | US
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Telephone | 575-624-7233
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Fax | 575-624-7100
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Authorized Official
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Title or Position | ASST. VP FOR EXTERNAL AFFAIRS
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Name | MRS. JANE BATSON
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Credential | RN
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Telephone | 575-624-7233
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251300000X
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Taxonomy Name | Local Education Agency (LEA)
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License Number |
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License Number State |
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