Provider Demographics
NPI:1891010369
Name:MONITORED MEDICAL LCC
Entity Type:Organization
Organization Name:MONITORED MEDICAL LCC
Other - Org Name:SIGNAL ALERT
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:CALDWELL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:505-275-6007
Mailing Address - Street 1:13170 CENTRAL AVE. SE
Mailing Address - Street 2:STE B #B309
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87123-5504
Mailing Address - Country:US
Mailing Address - Phone:505-275-6007
Mailing Address - Fax:505-889-0641
Practice Address - Street 1:10820 CENTRAL AVE SE
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87123-2728
Practice Address - Country:US
Practice Address - Phone:505-275-6007
Practice Address - Fax:505-889-0641
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-03-29
Last Update Date:2010-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM03169090004333300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333300000XSuppliersEmergency Response System Companies