Enchantment Medical Supply, LLC

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

Legal business name

ENCHANTMENT MEDICAL SUPPLY, LLC

Practice address

1124 S Solano Dr
Suite D
Las Cruces, NM 88001-3863

Phone

(915) 203-8108

Fax

(505) 532-5733

NPI assigned

May 13, 2006

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Godwin Enwongobong Udo Jr.

Title

Owner

Phone

(915) 203-8108

Specialties & licenses 1

Addresses

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1147478400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1193011200000",
    "number": "1760433940",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1557 MONTE VISTA AVE",
            "city": "LAS CRUCES",
            "state": "NM",
            "postal_code": "880015731",
            "telephone_number": "505-532-5700",
            "fax_number": "505-432-5733"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1124 S SOLANO DR",
            "address_2": "SUITE D",
            "city": "LAS CRUCES",
            "state": "NM",
            "postal_code": "880013863",
            "telephone_number": "915-203-8108",
            "fax_number": "505-532-5733"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ENCHANTMENT MEDICAL SUPPLY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-13",
        "last_updated": "2007-10-22",
        "status": "A",
        "authorized_official_last_name": "UDO",
        "authorized_official_first_name": "GODWIN",
        "authorized_official_middle_name": "ENWONGOBONG",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "915-203-8108",
        "authorized_official_name_suffix": "Jr."
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Godfrey L Encarnado
• Memoria Encee
• Enchantedjourneytherapeutics, LLC
• Enchantment Aviation
• Enchantment Aviation, Inc.
• Enchantment Orthodontics, LLC
• Endoscopy Center of Las Cruces
• Matthew Endrizzi, MD
• Energized Minds Therapy LLC
• Charles Jordan Enfield

• Durable Medical Equipment & Medical Supplies in Las Cruces, NM
• Providers in Las Cruces, NM by specialty
• Durable Medical Equipment & Medical Supplies in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.