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General NPI Number Information
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NPI Number | 1982528659
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Entity Type | Organization
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Legal Business Name | EXTRA MILE BUILDERS LLC
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Dates
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Enumeration Date | 08/06/2026
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Last Update Date | 08/06/2026
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Provider Practice Location Address
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Address Line | 2706 FLORAL RD NW
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City | ALBUQUERQUE
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State | NM
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Zip | 87104
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Country | US
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Telephone | 505-510-4182
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Fax |
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Provider Business Mailing Address
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Address Line | 11024 MONTGOMERY BLVD NE # 168
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City | ALBUQUERQUE
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State | NM
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Zip | 87111-3962
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Country | US
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Telephone | 505-510-4182
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Fax |
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Authorized Official
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Title or Position | GENERAL MANAGER
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Name | PAGE OLLICE
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Credential |
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Telephone | 505-510-4182
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 171W00000X
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Taxonomy Name | Contractor
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License Number |
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License Number State |
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