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NPI Code Detail

MEDICARE: SILVERSTONE HEALTHCARE OF BLOOMFIELD, LLC

MEDICARE: SILVERSTONE HEALTHCARE OF BLOOMFIELD, 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 Facility1036NM

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 : 1457306730
Entity Type Code : Organization
Provider Name (Legal Business Name) : SILVERSTONE HEALTHCARE OF BLOOMFIELD, LLC
Provider Business Mailing Address
First Line : 101 SUN AVE NE
Second Line :
City : ALBUQUERQUE
State : NM
Zip : 87109-4373
Country : US
Telephone Number : 505-821-3355
Fax Number : 505-468-4681
Provider Business Practice Location Address
First Line : 803 HACIENDA LN
Second Line :
City : BLOOMFIELD
State : NM
Zip : 87413-5109
Country : US
Telephone Number : 505-632-1823
Fax Number : 505-632-4572
Authorized Official
Title or Position : PRESIDENT/DIRECTOR
Name : WILLIAM A. MATHIES
Credential :
Telephone Number : 505-821-3355
Provider Enumeration Date : 05/24/2006
Last Update Date : 08/22/2020

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Directions to “SILVERSTONE HEALTHCARE OF BLOOMFIELD, LLC ” Practice Location

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