Provider Demographics
NPI:1760033153
Name:AVD HEALTHCARE, LLC
Entity Type:Organization
Organization Name:AVD HEALTHCARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ADAM
Authorized Official - Middle Name:
Authorized Official - Last Name:DOWNS
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:505-292-5875
Mailing Address - Street 1:3107 EUBANK BLVD NE STE 1
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87111-4845
Mailing Address - Country:US
Mailing Address - Phone:505-292-5875
Mailing Address - Fax:
Practice Address - Street 1:3107 EUBANK BLVD NE STE 1
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87111-4845
Practice Address - Country:US
Practice Address - Phone:505-292-5875
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-09-26
Last Update Date:2019-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service