Provider Demographics
NPI:1659607414
Name:BREATHEAMERICA ALBUQUERQUE, INC.
Entity Type:Organization
Organization Name:BREATHEAMERICA ALBUQUERQUE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:REPRESENTATIVE
Authorized Official - Prefix:
Authorized Official - First Name:CECILE
Authorized Official - Middle Name:
Authorized Official - Last Name:REED
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:505-883-2574
Mailing Address - Street 1:4901 LANG AVE NE
Mailing Address - Street 2:SUITE 100
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87109-4495
Mailing Address - Country:US
Mailing Address - Phone:505-883-2574
Mailing Address - Fax:505-883-0725
Practice Address - Street 1:4901 LANG AVE NE
Practice Address - Street 2:SUITE 100
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87109-4495
Practice Address - Country:US
Practice Address - Phone:505-883-2574
Practice Address - Fax:505-883-0725
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:BREATHEAMERICA, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2009-10-28
Last Update Date:2011-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207KA0200XAllopathic & Osteopathic PhysiciansAllergy & ImmunologyAllergyGroup - Single Specialty