Basic Information
| Provider Information | |||||||||
| NPI: | 1245336049 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | LOVELACE WOMEN'S HEALTH | ||||||||
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| Mailing Information | |||||||||
| Address1: | 4701 MONTGOMERY BLVD NE | ||||||||
| Address2: | |||||||||
| City: | ALBUQUERQUE | ||||||||
| State: | NM | ||||||||
| PostalCode: | 871091219 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5057277778 | ||||||||
| FaxNumber: | 5057277640 | ||||||||
| Practice Location | |||||||||
| Address1: | 4701 MONTGOMERY BLVD NE | ||||||||
| Address2: | |||||||||
| City: | ALBUQUERQUE | ||||||||
| State: | NM | ||||||||
| PostalCode: | 871091219 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5057277778 | ||||||||
| FaxNumber: | 5057277640 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/16/2006 | ||||||||
| LastUpdateDate: | 08/22/2020 | ||||||||
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| AuthorizedOfficialLastName: | MAGNES | ||||||||
| AuthorizedOfficialFirstName: | HARRY | ||||||||
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| AuthorizedOfficialTitleorPosition: | CEO | ||||||||
| AuthorizedOfficialTelephone: | 5052623085 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | MD | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | Y | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Internal Medicine |
No ID Information.