PECOS VALLEY OF NEW MEXICO LLC NPI 1699918672

Durable Medical Equipment & Medical Supplies in Carlsbad, NM

Organization Durable Medical Equipment & Medical Supp... CLIA Record

About PECOS VALLEY OF NEW MEXICO LLC

Pecos Valley Of New Mexico Llc is a provider established in Carlsbad, New Mexico specializing in durable medical equipment & medical supplies. The NPI number of Pecos Valley Of New Mexico Llc is 1699918672 and was assigned on April 2009. The practitioner's primary taxonomy code is 332B00000X. The provider is registered as an organization and their NPI record was last updated 8 years ago.
The authorized official of this NPI record is Debbie T. Brewer (Director)

NPI

1699918672

Provider NamePECOS VALLEY OF NEW MEXICO LLC
Provider Location Address2402 W PIERCE ST SUITE 6E CARLSBAD, NM 88220
Provider Mailing Address2402 W PIERCE ST SUITE 6E CARLSBAD, NM 88220
NPI Entity TypeOrganization
Is Sole Proprietor?N/A
Is Organization Subpart?No
Enumeration Date04-07-2009
Last Update Date12-01-2011

Primary Taxonomy

Taxonomy Code332B00000X
ClassificationDurable Medical Equipment & Medical Supplies
TypeSuppliers
Taxonomy DescriptionA supplier of medical equipment such as respirators, wheelchairs, home dialysis systems, or monitoring systems, that are prescribed by a physician for a patient’s use in the home and that are usable for an extended period of time.

Business Address

PECOS VALLEY OF NEW MEXICO LLC
2402 W PIERCE ST
SUITE 6E
CARLSBAD, NM
ZIP 88220
Phone: (575) 628-0312

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Mailing Address

PECOS VALLEY OF NEW MEXICO LLC
2402 W PIERCE ST
SUITE 6E
CARLSBAD, NM
ZIP 88220
Phone: (575) 628-0312

Authorized Official

Authorized Official Name DEBBIE T. BREWER
Authorized Official TitleDIRECTOR
Authorized Official Phone(877) 892-9813

CLIA Information

The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates.

CLIA Number32D0991385
Facility TypePHYSICIAN OFFICE
Certificate TypeWaiver

Additional Identifiers


Additional identifier(s) currently or formerly used as an identifier for the provider. The codes may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.

Identifier Type / Code Identifier State
6028770002MEDICARE NSC (07)NM
B4739MEDICAID (05)NM
400521070MEDICARE PIN (08)NM

Other Providers at the same location


The following 20 providers are registered at the same or nearby location.

NPI Name / Type Taxonomy Address
1003801572MR. JOHN (JACK) SILVIO VOLPATO JR. RPH,PHC
Individual
Pharmacist2402 W PIERCE ST 1-A
CARLSBAD, NM 88220
(505) 887-6611
1023009016DR. KIM P LARK D.O.
Individual
Family Medicine2402 W PIERCE ST SUITE 4-A
CARLSBAD, NM 88220
(575) 234-9964
1104167477 JILL FIERRO FNP
Individual
Nurse Practitioner (Family)2402 W PIERCE ST STE 4A
CARLSBAD, NM 88220
(575) 234-9964
1245519115RANEY PEDIATRICS
Organization
Pediatrics2402 W PIERCE ST SUITE 3 C
CARLSBAD, NM 88220
(575) 887-0530
1265835284DR. APOORVA REDDY TIPARTI PHARM.D.
Individual
Pharmacist2402 W PIERCE ST SUITE 1A
CARLSBAD, NM 88220
(575) 887-6611
1285812990DILIP D. MADNANI, M.D., LLC
Organization
Otolaryngology2402 W PIERCE ST SUITE 3C
CARLSBAD, NM 88220
(575) 887-9528
1437144474MRS. HEIDI K. GOODEY RPH
Individual
Pharmacist2402 W PIERCE ST
CARLSBAD, NM 88220
(505) 885-2979
1598784571MS. LYNDA S. BICKERSTAFF RN, MSN, CNS, CWOCN
Individual
Clinical Nurse Specialist2402 W PIERCE ST SUITE 5A
CARLSBAD, NM 88220
(575) 887-5321
1629066501DR. RICHARD JAMES DAVIES DO
Individual
2402 W PIERCE ST 3 C
CARLSBAD, NM 88220
(505) 887-0771
1639178338MR. JOSEPH DANIEL CROSS PHARMACIST
Individual
Pharmacist2402 W PIERCE ST SUITE 1A
CARLSBAD, NM 88220
(505) 887-6611
1639285208 JEREMIAH KENT RANEY MD
Individual
Pediatrics2402 W PIERCE ST STE 3C
CARLSBAD, NM 88220
(575) 887-0530
1699781138DR. MICHAEL G. LIM M.D.
Individual
Ophthalmology2402 W PIERCE ST SUITE 1B
CARLSBAD, NM 88220
(575) 887-5325
1700810959CORNER DRUG STORE, INC.
Organization
Pharmacy (Community/Retail Pharmacy)2402 W PIERCE ST SUITE 1A
CARLSBAD, NM 88220
(505) 887-6611
1700923877 MARK A K HOWARD M.D.
Individual
Internal Medicine2402 W PIERCE ST SUITE 6A
CARLSBAD, NM 88220
(575) 885-1970
1720275357KIM P LARK DO PC
Organization
Family Medicine2402 W PIERCE ST STE 4A
CARLSBAD, NM 88220
(505) 234-9964
1790771558MR. NEAL CLIFFORD DUNGAN
Individual
Pharmacist2402 W PIERCE ST SUITE 2B
CARLSBAD, NM 88220
(505) 885-2979
1821199886MR. WALTER A. ALLERY MS/CCC-A
Individual
Audiologist-Hearing Aid Fitter2402 W PIERCE ST SUITE 3C
CARLSBAD, NM 88220
(505) 234-1531
1902862832 SHILA RAMAKRISHNA MD
Individual
Pediatrics2402 W PIERCE ST STE 6F
CARLSBAD, NM 88220
(505) 628-3244
1942554480SANDYA SURGICAL ASSOCIATES
Organization
Surgery2402 W PIERCE ST SUITE 5C
CARLSBAD, NM 88220
(575) 725-5755
1982905683MRS. IDA LEE FRASER CNP
Individual
Nurse Practitioner (Family)2402 W PIERCE ST SUITE 4A
CARLSBAD, NM 88220
(575) 234-9964

NPI Footnotes

What is the National Provider Indentifier (NPI)?
The NPI is 10-position all-numeric identification number assigned by the NPPES to uniquely identify a health care provider.

Provider Location Address
The location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.

Provider Mailing Address
The mailing address of the provider being identified. This address may contain the same information as the provider location address.

Entity Type Code
The code describing the type of health care provider that is being assigned an NPI.
The entity type codes are:
1 = Person: individual human being who furnishes health care;
2 = Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)

What is a Subpart?
Subparts are the components and separate physical locations of organization health care providers. Subpart examples include:
Hospital components include outpatient departments, surgical centers, psychiatric units, and laboratories. These components are often separately licensed or certified by States and may exist at physical locations other than that of the hospital of which they are a component.

Provider Other Organization Name
The other organization name is the alternative last name by which the provider is or has been known (if an individual) or other name by which the organization provider is or has been known. The code identifying the type of other name. The provider other organization name codes are:
1 = former name;
2 = professional name;
3 = doing business as (d/b/ a) name;
4 = former legal business name; :
5 = other.

Provider Enumeration Date
The date the provider was assigned a unique identifier (assigned an NPI).

Last Update Date
The date that a NPI record was last updated or changed.

Primary Taxonomy Code
The primary taxonomy code defines the provider type, classification, and specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Authorized Official Name
The name of the person authorized to submit the NPI application or to officially change data for a health care provider.

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