Provider Demographics
NPI:1255503066
Name:S.K. JARAMILLO ENTERPRIZES
Entity Type:Organization
Organization Name:S.K. JARAMILLO ENTERPRIZES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SHANE
Authorized Official - Middle Name:
Authorized Official - Last Name:JARAMILLO
Authorized Official - Suffix:
Authorized Official - Credentials:HIS
Authorized Official - Phone:505-881-3304
Mailing Address - Street 1:2839 CARLISLE BLVD NE STE 110
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87110-2877
Mailing Address - Country:US
Mailing Address - Phone:505-881-3304
Mailing Address - Fax:505-325-5416
Practice Address - Street 1:2839 CARLISLE BLVD NE STE 110
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87110-2877
Practice Address - Country:US
Practice Address - Phone:505-881-3304
Practice Address - Fax:505-325-5416
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-01
Last Update Date:2008-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM502332S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332S00000XSuppliersHearing Aid Equipment