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General NPI Number Information
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NPI Number | 1891562849
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Entity Type | Organization
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Legal Business Name | ACCREDO CARE LLC
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Dates
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Enumeration Date | 12/11/2023
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Last Update Date | 02/19/2024
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Provider Practice Location Address
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Address Line | 1050 KENNEDY RD
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City | LAS CRUCES
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State | NM
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Zip | 88007-5761
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Country | US
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Telephone | 575-232-7460
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Fax | 575-223-0769
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Provider Business Mailing Address
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Address Line | PO BOX 13372
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City | LAS CRUCES
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State | NM
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Zip | 88013-3372
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Country | US
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Telephone | 575-232-7460
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Fax | 575-223-0769
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Authorized Official
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Title or Position | CHIEF EXECUTIVE OFFICER
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Name | ANTONIO JOSHUA VALENZUELA
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Credential |
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Telephone | 575-232-7460
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 342000000X
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Taxonomy Name | Transportation Network Company
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License Number |
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License Number State |
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