Provider Demographics
NPI:1295544047
Name:MEDICALON
Entity type:Organization
Organization Name:MEDICALON
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:TYLER
Authorized Official - Middle Name:AARON
Authorized Official - Last Name:NAFUS
Authorized Official - Suffix:
Authorized Official - Credentials:RN-BSN
Authorized Official - Phone:505-604-5838
Mailing Address - Street 1:2749 WILDER LOOP NE
Mailing Address - Street 2:
Mailing Address - City:RIO RANCHO
Mailing Address - State:NM
Mailing Address - Zip Code:87144-1441
Mailing Address - Country:US
Mailing Address - Phone:505-604-5838
Mailing Address - Fax:
Practice Address - Street 1:2749 WILDER LOOP NE
Practice Address - Street 2:
Practice Address - City:RIO RANCHO
Practice Address - State:NM
Practice Address - Zip Code:87144-1441
Practice Address - Country:US
Practice Address - Phone:505-604-5838
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-01-06
Last Update Date:2025-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No251J00000XAgenciesNursing Care
No251K00000XAgenciesPublic Health or Welfare
No261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service