Provider Demographics
NPI:1114949781
Name:CARLSBAD MEDICAL CENTER LLC
Entity Type:Organization
Organization Name:CARLSBAD MEDICAL CENTER LLC
Other - Org Name:CARLSBAD MEDICAL CENTER - REHAB
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR/DELEGATED OFFICIAL
Authorized Official - Prefix:
Authorized Official - First Name:PAULA
Authorized Official - Middle Name:M
Authorized Official - Last Name:LALOR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:629-215-3953
Mailing Address - Street 1:2430 W PIERCE ST
Mailing Address - Street 2:
Mailing Address - City:CARLSBAD
Mailing Address - State:NM
Mailing Address - Zip Code:88220-3553
Mailing Address - Country:US
Mailing Address - Phone:505-887-4100
Mailing Address - Fax:505-887-4256
Practice Address - Street 1:2430 W PIERCE ST
Practice Address - Street 2:
Practice Address - City:CARLSBAD
Practice Address - State:NM
Practice Address - Zip Code:88220-3553
Practice Address - Country:US
Practice Address - Phone:505-887-4100
Practice Address - Fax:505-887-4256
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CARLSBAD MEDICAL CENTER LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-07-24
Last Update Date:2021-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM6744273Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes273Y00000XHospital UnitsRehabilitation Unit
Provider Identifiers
StateIdentifier IDID TypeIssuer
32T063Medicare Oscar/Certification