Provider Demographics
NPI:1811345549
Name:INVERSE MEDICAL, LLC
Entity type:Organization
Organization Name:INVERSE MEDICAL, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:JOHONNIUSS
Authorized Official - Middle Name:
Authorized Official - Last Name:CHEMWENO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:505-816-8014
Mailing Address - Street 1:PO BOX 90056
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87199-0056
Mailing Address - Country:US
Mailing Address - Phone:505-816-8014
Mailing Address - Fax:505-212-0553
Practice Address - Street 1:4904 ALAMEDA BLVD NE STE B
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87113-2385
Practice Address - Country:US
Practice Address - Phone:505-389-2279
Practice Address - Fax:505-212-0553
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-06-03
Last Update Date:2023-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No227800000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRespiratory Therapist, CertifiedGroup - Multi-Specialty
No251V00000XAgenciesVoluntary or CharitableGroup - Multi-Specialty
No251X00000XAgenciesSupports Brokerage
No343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
Provider Identifiers
StateIdentifier IDID TypeIssuer
NM19121342Medicaid