Provider Demographics
NPI:1891562849
Name:ACCREDO CARE LLC
Entity Type:Organization
Organization Name:ACCREDO CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:ANTONIO
Authorized Official - Middle Name:JOSHUA
Authorized Official - Last Name:VALENZUELA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:575-232-7460
Mailing Address - Street 1:PO BOX 13372
Mailing Address - Street 2:
Mailing Address - City:LAS CRUCES
Mailing Address - State:NM
Mailing Address - Zip Code:88013-3372
Mailing Address - Country:US
Mailing Address - Phone:575-232-7460
Mailing Address - Fax:575-223-0769
Practice Address - Street 1:1050 KENNEDY RD
Practice Address - Street 2:
Practice Address - City:LAS CRUCES
Practice Address - State:NM
Practice Address - Zip Code:88007-5761
Practice Address - Country:US
Practice Address - Phone:575-232-7460
Practice Address - Fax:575-223-0769
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-12-11
Last Update Date:2024-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes342000000XTransportation ServicesTransportation Network Company