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General NPI Number Information
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NPI Number | 1891010369
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Entity Type | Organization
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Legal Business Name | MONITORED MEDICAL LCC
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Dates
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Enumeration Date | 03/29/2010
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Last Update Date | 03/29/2010
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Provider Practice Location Address
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Address Line | 10820 CENTRAL AVE SE
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City | ALBUQUERQUE
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State | NM
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Zip | 87123-2728
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Country | US
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Telephone | 505-275-6007
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Fax | 505-889-0641
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Provider Business Mailing Address
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Address Line | 13170 CENTRAL AVE. SE STE B #B309
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City | ALBUQUERQUE
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State | NM
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Zip | 87123-5504
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Country | US
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Telephone | 505-275-6007
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Fax | 505-889-0641
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. MICHAEL CALDWELL
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Credential |
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Telephone | 505-275-6007
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 333300000X
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Taxonomy Name | Emergency Response System Companies
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License Number | 03169090004
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License Number State | NM
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