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NPI Code Detail

MEDICARE: 369 ALBUQUERQUE OPS LLC

MEDICARE: 369 ALBUQUERQUE OPS 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 Facility

General Provider Information

NPI Number : 1578344818
Entity Type Code : Organization
Provider Name (Legal Business Name) : 369 ALBUQUERQUE OPS LLC
Provider Business Mailing Address
First Line : 2000 PGA BLVD STE 3230
Second Line :
City : PALM BEACH GARDENS
State : FL
Zip : 33408-2718
Country : US
Telephone Number : 561-801-4235
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 : MANAGER
Name : MR. ROBERT C CAMPION
Credential :
Telephone Number : 561-386-1590
Provider Enumeration Date : 10/12/2023
Last Update Date : 10/12/2023

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Directions to “369 ALBUQUERQUE OPS LLC ” Practice Location

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