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General NPI Number Information
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NPI Number | 1831672054
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Entity Type | Organization
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Legal Business Name | HEALTHBRIDGE MEDICAL AND REHABILITATIVE SERVICES LLC
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Dates
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Enumeration Date | 09/13/2018
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Last Update Date | 01/24/2023
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Provider Practice Location Address
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Address Line | 200 W 1ST ST STE 530
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City | ROSWELL
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State | NM
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Zip | 88203-4676
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Country | US
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Telephone | 575-363-8178
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Fax | 855-655-2476
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Provider Business Mailing Address
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Address Line | 500 N KENTUCKY AVE
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City | ROSWELL
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State | NM
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Zip | 88201-4721
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Country | US
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Telephone | 575-363-8178
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Fax |
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | DR. FRANCIS IAN C BICOL
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Credential | DNP, CRNA
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Telephone | 575-363-8178
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number |
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License Number State |
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