MEDICARE: DCI DONOR SERVICES INC.

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
1	335U00000X	Organ Procurement Organization	32P001	NM

General Provider Information

NPI Number	:	1285159467
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DCI DONOR SERVICES INC.

Provider Business Mailing Address
First Line	:	1600 HAYES ST STE 300
Second Line	:
City	:	NASHVILLE
State	:	TN
Zip	:	37203-3034
Country	:	US
Telephone Number	:	615-234-5251
Fax Number	:	615-564-3922

Provider Business Practice Location Address
First Line	:	1609 UNIVERSITY BLVD NE
Second Line	:
City	:	ALBUQUERQUE
State	:	NM
Zip	:	87102-1710
Country	:	US
Telephone Number	:	505-843-7672
Fax Number	:	505-353-5301

Authorized Official
Title or Position	:	CHIEF FINANCIAL OFFICER
Name	:	TERESA THOMPSON
Credential	:
Telephone Number	:	615-564-3621

Provider Enumeration Date	:	08/08/2017
Last Update Date	:	08/08/2017

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