Decker, Lawrence Andrew

Decker, Lawrence Andrew is an sole proprietor health care provider with primary practice located at 3451 N Butler Ave , Farmington NM 87401. He recently has only one registered license in Ambulatory Health Care Facilities / Urgent Care, which is considered as his primary health care specialty. Decker, Lawrence Andrew can be contacted via phone (505) 566-1915.

Contact Information

Primary practice address
3451 N Butler Ave Farmington NM 87401
Phone: (505) 566-1915
Fax: (505) 566-1918
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Ambulatory Health Care Facilities / Urgent Care 261QU0200X PA2006-0011 New Mexico

Profile Details

NPI number 1093706699
LBN Legal business name Decker, Lawrence Andrew
Credentials PAC
Entity Individual
Sole proprietor 1 Yes
Enumeration date Nov 2nd, 2005
Last updated Apr 23rd, 2021 - about 5 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1093706699 NPPES
New Mexico MEDICAID 66439833
New Mexico MEDICAID 875114
New Mexico MEDICAID 19375336

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