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Contact Information

MEDISOURCE HOME HEALTH
406 W COLLEGE BLVD STE A
ROSWELL, NM88201-5114
 Phone: 575-910-5521
 Fax: 575-208-1769
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Home Health

251E00000X A4[11] Home Health Agency
Indicates primary specialty

NPI Profile & details for MEDISOURCE HOME HEALTH

NPI Number 1639512171
LBN Legal business name MEDISOURCE HOME HEALTH
Authorized official REBECCA THOMPSON-RAMIREZ - (ADMINISTRATOR/OWNER)
Entity Organization
Organization subpart 1 No
Enumeration date 04/15/2013
Last updated 03/17/2018 - About 8 years ago
Identifiers
NM License # 3434
NM Medicaid 70683255
NM Other 1T3434 NM HEALTH AND LICENSING
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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