Mederi Life Llc
LBN: Mederi Life Llc
Mederi Life Llc is an health care organization with primary practice located at 6200 Coors Blvd Nw Ste A8 , Albuquerque NM 87120-2794. The organization recently has 3 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Family Medicine, Ambulatory Health Care Facilities / Health Service, Ambulatory Health Care Facilities / Primary Care. Allopathic & Osteopathic Physicians / Family Medicine is the primary health care specialty.
Mederi Life Llc can be contacted via phone (505) 433-4007, or through Padilla, Lisa via phone (505) 385-9060.
Contact Information
Primary practice address
6200 Coors Blvd Nw Ste A8
Albuquerque NM 87120-2794
Phone: (505) 433-4007
Fax: (505) 433-4068
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | ||
| Ambulatory Health Care Facilities / Health Service | 261QH0100X | ||
| Ambulatory Health Care Facilities / Primary Care | 261QP2300X |
Profile Details
| NPI number | 1649834904 |
|---|---|
| LBN Legal business name | Mederi Life Llc |
| DBA Doing business as | |
| Authorized official | Padilla, Lisa |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | Apr 23rd, 2019 |
| Last updated | Oct 4th, 2021 - about 5 years ago |
1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1649834904 | NPPES |
| New Mexico | Other | 1649834904 | GROUP NPI |
| New Mexico | MEDICAID | 21089248 | GROUP NPI |
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