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NPI Code Detail

MEDICARE: WW HEALTHCARE LLC

MEDICARE: WW HEALTHCARE LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1314000000XSkilled Nursing Facility1077NM

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1003091521
Entity Type Code : Organization
Provider Name (Legal Business Name) : WW HEALTHCARE LLC
Provider Business Mailing Address
First Line : 500 LOUISIANA BLVD NE
Second Line :
City : ALBUQUERQUE
State : NM
Zip : 87108-2051
Country : US
Telephone Number : 505-255-1717
Fax Number :
Provider Business Practice Location Address
First Line : 500 LOUISIANA BLVD NE
Second Line :
City : ALBUQUERQUE
State : NM
Zip : 87108-2051
Country : US
Telephone Number : 505-255-1717
Fax Number :
Authorized Official
Title or Position : EXECUTIVE DIRECTOR
Name : MR. HORACE WINCHESTER
Credential :
Telephone Number : 312-255-1514
Provider Enumeration Date : 01/03/2008
Last Update Date : 07/14/2008

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Directions to “WW HEALTHCARE LLC ” Practice Location

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