1932297348 NPI number — MS. ELEANOR P TOYA SW

Table of content: MS. ELEANOR P TOYA SW (NPI 1932297348)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1932297348 NPI number — MS. ELEANOR P TOYA SW

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
TOYA
Provider First Name:
ELEANOR
Provider Middle Name:
P
Provider Name Prefix Text:
MS.
Provider Name Suffix Text:
Provider Credential Text:
SW
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1932297348
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/08/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 130
Provider Second Line Business Mailing Address:
ACOMA CANONCITO LABRUNIA INDIAN HOSP
Provider Business Mailing Address City Name:
SAN FIDEL
Provider Business Mailing Address State Name:
NM
Provider Business Mailing Address Postal Code:
87049
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
505-552-5315
Provider Business Mailing Address Fax Number:
505-552-5491

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
EXIT I 40 EXIT 102
Provider Second Line Business Practice Location Address:
ACL HOSPITAL
Provider Business Practice Location Address City Name:
SAN FIDEL
Provider Business Practice Location Address State Name:
NM
Provider Business Practice Location Address Postal Code:
87049
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
505-552-5315
Provider Business Practice Location Address Fax Number:
505-552-5491
Provider Enumeration Date:
10/11/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 104100000X , with the licence number:  M2460 , registered in the state of NM ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 92936067 , issued by the state of ( NM ) . This identifiers is of the category "MEDICAID".




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