Provider Demographics
NPI:1932163326
Name:FRONTIER MEDICAL EQUIPMENT, INC.
Entity Type:Organization
Organization Name:FRONTIER MEDICAL EQUIPMENT, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:MISS
Authorized Official - First Name:CORINA
Authorized Official - Middle Name:CHAVES
Authorized Official - Last Name:SAMBRANO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:505-257-2536
Mailing Address - Street 1:613 SUDDERTH DR
Mailing Address - Street 2:STE K
Mailing Address - City:RUIDOSO
Mailing Address - State:NM
Mailing Address - Zip Code:88345-6213
Mailing Address - Country:US
Mailing Address - Phone:505-257-2536
Mailing Address - Fax:505-257-6401
Practice Address - Street 1:613 SUDDERTH DR
Practice Address - Street 2:STE K
Practice Address - City:RUIDOSO
Practice Address - State:NM
Practice Address - Zip Code:88345-6213
Practice Address - Country:US
Practice Address - Phone:505-257-2536
Practice Address - Fax:505-257-6401
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-13
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
NMNM00T27HOtherBCBS OF NM
NM000B6991Medicaid
NM1284640001Medicare ID - Type Unspecified