Ruben A. Supan, Llc

LBN: Ruben A. Supan, Llc
Ruben A. Supan, Llc is an health care organization with primary practice located at 405 W Country Club Rd , Roswell NM 88201-5209. The organization recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Family, which is considered as the primary health care specialty. Ruben A. Supan, Llc can be contacted via phone (575) 363-3134, or through Supan, Ruben via phone (505) 409-0831.

Contact Information

Primary practice address
405 W Country Club Rd Roswell NM 88201-5209
Phone: (575) 363-3134
Fax: (575) 208-0780
Website:
Map and Directions
Authorized official contact:
Name: Supan, Ruben Nurse Practitioner (NP)
Phone: (505) 409-0831

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X

Profile Details

NPI number 1053802892
LBN Legal business name Ruben A. Supan, Llc
DBA Doing business as
Authorized official Supan, Ruben Nurse Practitioner (NP)
Entity Organization
Organization subpart 1 No
Enumeration date May 29th, 2018
Last updated Jul 6th, 2021 - about 3 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1053802892 NPPES
New Mexico MEDICAID 23386363

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