Davita Medical Group
LBN: Optumcare New Mexico, Llc
Davita Medical Group is an health care organization with primary practice located at 5150 Journal Center Blvd Ne , Albuquerque NM 87109-5900. The organization recently has 9 registered licenses in different health care specialties including Technologists, Technicians & Other Technical Service Providers / Radiologic Technologist, Technologists, Technicians & Other Technical Service Providers / Bone Densitometry, Technologists, Technicians & Other Technical Service Providers / Computed Tomography, Technologists, Technicians & Other Technical Service Providers / Radiography, Technologists, Technicians & Other Technical Service Providers / Magnetic Resonance Imaging, Technologists, Technicians & Other Technical Service Providers / Mammography, Technologists, Technicians & Other Technical Service Providers / Sonography, Technologists, Technicians & Other Technical Service Providers / Vascular Sonography, Technologists, Technicians & Other Technical Service Providers / Vascular-Interventional Technology. Technologists, Technicians & Other Technical Service Providers / Radiologic Technologist is the primary health care specialty.
Optumcare New Mexico, Llc can be contacted via phone (505) 232-1500, or through Liethen, John G via phone (952) 205-6262.
Contact Information
Primary practice address
5150 Journal Center Blvd Ne
Albuquerque NM 87109-5900
Phone: (505) 232-1500
Fax: (505) 232-1584
Website:
Health care specialties
Profile Details
| NPI number | 1245494723 |
|---|---|
| LBN Legal business name | Optumcare New Mexico, Llc |
| DBA Doing business as | Davita Medical Group |
| Authorized official | Liethen, John G |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | Jul 15th, 2008 |
| Last updated | Aug 20th, 2019 - 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 | 1245494723 | NPPES |
| New Mexico | MEDICAID | 93670567 |
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