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Contact Information

SANDROCK PODIATRY LLC
4707 RIO ST
FARMINGTON, NM87402-5323
 Phone: 505-787-9035
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Podiatrist

213E00000X 48 Podiatry
 

Primary Podiatric Medicine

213EP1101X 48 Podiatry
Indicates primary specialty

NPI Profile & details for SANDROCK PODIATRY LLC

NPI Number 1124809066
LBN Legal business name SANDROCK PODIATRY LLC
Authorized official ERIC HAAG - (OWNER/PODIATRIST)
Entity Organization
Organization subpart 1 No
Enumeration date 10/06/2023
Last updated 08/23/2024 - More than a year ago
Identifiers
NM Medicaid 74122355
NM Other 6N8581 NM-GROUP MEDICARE PTAN
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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