Provider Demographics
NPI:1841270121
Name:KAREN A MARTIN
Entity type:Organization
Organization Name:KAREN A MARTIN
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KAREN
Authorized Official - Middle Name:A
Authorized Official - Last Name:MARTIN
Authorized Official - Suffix:
Authorized Official - Credentials:KAREN A MARTIN
Authorized Official - Phone:575-746-1883
Mailing Address - Street 1:PO BOX 12
Mailing Address - Street 2:
Mailing Address - City:ARTESIA
Mailing Address - State:NM
Mailing Address - Zip Code:88211-0012
Mailing Address - Country:US
Mailing Address - Phone:575-746-1883
Mailing Address - Fax:575-746-1885
Practice Address - Street 1:611 W MAHONE DR STE D
Practice Address - Street 2:
Practice Address - City:ARTESIA
Practice Address - State:NM
Practice Address - Zip Code:88210-2075
Practice Address - Country:US
Practice Address - Phone:575-746-1883
Practice Address - Fax:575-746-1885
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-01-20
Last Update Date:2025-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
332BX2000X
NM02406754007332BX2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
NM000Z6946Medicaid
NM000Z6946Medicaid