Provider Demographics
NPI:1396215075
Name:NEW MEXICO NATIVE CARE LLC
Entity Type:Organization
Organization Name:NEW MEXICO NATIVE CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:AHMED
Authorized Official - Middle Name:ABDALLA
Authorized Official - Last Name:GUREYE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:480-239-7544
Mailing Address - Street 1:5401 E VAN BUREN ST UNIT 1023
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85008-3457
Mailing Address - Country:US
Mailing Address - Phone:480-239-7544
Mailing Address - Fax:
Practice Address - Street 1:5401 E VAN BUREN ST UNIT 1023
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85008-3457
Practice Address - Country:US
Practice Address - Phone:480-239-7544
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-11-26
Last Update Date:2018-11-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes344600000XTransportation ServicesTaxi