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NPI Code Detail

MEDICARE: LAUREL HEALTHCARE LLC

MEDICARE: LAUREL 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 Facility5241NM

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
23200534761OTHERCLIA

General Provider Information

NPI Number : 1205929189
Entity Type Code : Organization
Provider Name (Legal Business Name) : LAUREL HEALTHCARE LLC
Provider Business Mailing Address
First Line : 103 HOSPITAL LOOP NE
Second Line :
City : ALBUQUERQUE
State : NM
Zip : 87109-2115
Country : US
Telephone Number : 505-348-8300
Fax Number : 505-348-8270
Provider Business Practice Location Address
First Line : 103 HOSPITAL LOOP NE
Second Line :
City : ALBUQUERQUE
State : NM
Zip : 87109-2115
Country : US
Telephone Number : 505-348-8300
Fax Number : 505-348-8270
Authorized Official
Title or Position : MEMBER
Name : MR. ALAN ZAMPINI
Credential :
Telephone Number : 505-304-5152
Provider Enumeration Date : 10/02/2006
Last Update Date : 08/05/2008

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Directions to “LAUREL HEALTHCARE LLC ” Practice Location

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