MEDICARE: NEW MEXICO HIGHLANDS UNIVERSITY

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	171W00000X	Contractor

General Provider Information

NPI Number	:	1558599878
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NEW MEXICO HIGHLANDS UNIVERSITY

Provider Business Mailing Address
First Line	:	1031 11TH STREET
Second Line	:	ROOM 123 AND SUITE133
City	:	LAS VEGAS
State	:	NM
Zip	:	87701
Country	:	US
Telephone Number	:	505-454-3509
Fax Number	:	505-454-3524

Provider Business Practice Location Address
First Line	:	1031 11TH STREET
Second Line	:	ROOM 123 AND SUITE133
City	:	LAS VEGAS
State	:	NM
Zip	:	87701-9000
Country	:	US
Telephone Number	:	505-454-3509
Fax Number	:	505-454-3524

Authorized Official
Title or Position	:	DIRECTOR
Name	:	DR. JAMES M ALARID
Credential	:	PH.D.
Telephone Number	:	505-454-3509

Provider Enumeration Date	:	06/25/2009
Last Update Date	:	06/25/2009

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