Eduardo Bautista

Individual provider Active NPI In Home Supportive Care Agency · Anthony, NM

NPI 1003607920 · NPPES record last updated May 13, 2025

Key facts

NPI
1003607920
Entity type
Individual (NPI type 1)
Primary specialty
In Home Supportive Care Agency 253Z00000X
Practice address
224 Anthony Dr Ste B
Anthony, NM 88021-9190
Phone
(360) 360-8539
NPI assigned
May 13, 2025
Sex
Male
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X
Home Health Aide 374U00000X
In Home Supportive Care Agency 253Z00000X Yes

Addresses

Primary practice location

224 Anthony Dr Ste B
Anthony, NM 88021-9190

Mailing address

224 Anthony Dr Ste B
Anthony, NM 88021-9190
Phone (360) 360-8539

Other providers in Anthony, NM

All providers in Anthony, NM · In Home Supportive Care Agency in New Mexico

Sources for this page

Verify at the official NPI Registry.