Provider Demographics
NPI:1417183575
Name:ALTOMAR MEDICAL EQUIPMENT COMPANY, LLC
Entity Type:Organization
Organization Name:ALTOMAR MEDICAL EQUIPMENT COMPANY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:CHRISTOPHER
Authorized Official - Middle Name:ANTHONY
Authorized Official - Last Name:MARTINEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:915-422-0580
Mailing Address - Street 1:5312 RIO BRAVO DR
Mailing Address - Street 2:SUITE 7
Mailing Address - City:SANTA TERESA
Mailing Address - State:NM
Mailing Address - Zip Code:88008-9210
Mailing Address - Country:US
Mailing Address - Phone:575-874-2211
Mailing Address - Fax:575-874-2212
Practice Address - Street 1:5312 RIO BRAVO DR
Practice Address - Street 2:SUITE 7
Practice Address - City:SANTA TERESA
Practice Address - State:NM
Practice Address - Zip Code:88008-9210
Practice Address - Country:US
Practice Address - Phone:575-874-2211
Practice Address - Fax:575-874-2212
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-06-03
Last Update Date:2010-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM4137873332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
NM6274810001Medicare NSC