Provider Demographics
NPI:1245639756
Name:VACCINES FOR HEALTH
Entity type:Organization
Organization Name:VACCINES FOR HEALTH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:NANCI
Authorized Official - Middle Name:
Authorized Official - Last Name:BALDWIN
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:505-881-8785
Mailing Address - Street 1:1717 LOUISIANA BLVD NE
Mailing Address - Street 2:SUITE 212
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87110-7001
Mailing Address - Country:US
Mailing Address - Phone:505-881-8785
Mailing Address - Fax:
Practice Address - Street 1:1717 LOUISIANA BLVD NE
Practice Address - Street 2:SUITE 212
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87110-7001
Practice Address - Country:US
Practice Address - Phone:505-881-8785
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:NANULIA PC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2014-08-20
Last Update Date:2015-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM89-1422083X0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2083X0100XAllopathic & Osteopathic PhysiciansPreventive MedicineOccupational MedicineGroup - Single Specialty