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General NPI Number Information
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NPI Number | 1992832455
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Entity Type | Organization
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Legal Business Name | NATIVE RESOURCE DEVELOPMENT COMPANY INC.
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Dates
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Enumeration Date | 02/28/2007
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Last Update Date | 07/01/2024
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Provider Practice Location Address
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Address Line | 318 DEE ANN AVE
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City | GALLUP
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State | NM
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Zip | 87301-5783
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Country | US
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Telephone | 505-726-0201
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Fax | 505-726-0202
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Provider Business Mailing Address
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Address Line | 318 DEE ANN AVE
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City | GALLUP
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State | NM
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Zip | 87301-5783
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Country | US
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Telephone | 505-726-0201
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Fax | 505-726-0202
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Authorized Official
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Title or Position | OWNER
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Name | PENNY EMERSON
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Credential |
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Telephone | 505-867-5372
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 253Z00000X
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Taxonomy Name | In Home Supportive Care Agency
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License Number | 777245
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License Number State | AZ
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Taxonomy #2
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Taxonomy Code | 343900000X
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Taxonomy Name | Non-emergency Medical Transport (VAN)
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License Number | 30550297
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License Number State | NM
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Taxonomy #3
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Taxonomy Code | 343900000X
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Taxonomy Name | Non-emergency Medical Transport (VAN)
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License Number | 073338
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License Number State | AZ
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Taxonomy #4
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Taxonomy Code | 253Z00000X
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Taxonomy Name | In Home Supportive Care Agency
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License Number | 24855731
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License Number State | NM
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