| Lavender Medicine Llc | |
|
2201 Menaul Blvd Ne Ste A Albuquerque NM 87107-1711 | |
| (505) 933-9320 | |
| Not Available |
| Full Name | Lavender Medicine Llc |
|---|---|
| Speciality | Family Medicine |
| Location | 2201 Menaul Blvd Ne Ste A, Albuquerque, New Mexico |
| Authorized Official Name and Position | David William Lavender (OWNER) |
| Authorized Official Contact | 5059339320 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Lavender Medicine Llc 2201 Menaul Blvd Ne Ste A Albuquerque NM 87107-1711 Ph: () - | Lavender Medicine Llc 2201 Menaul Blvd Ne Ste A Albuquerque NM 87107-1711 Ph: (505) 933-9320 |
| NPI Number | 1801576038 |
|---|---|
| Provider Enumeration Date | 07/21/2023 |
| Last Update Date | 07/21/2023 |
| Medicare PECOS PAC ID | 3173968740 |
|---|---|
| Medicare Enrollment ID | O20240305003301 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1801576038 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | David W Lavender |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1265098214 PECOS PAC ID: 5890022842 Enrollment ID: I20240305003415 |
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