Provider Demographics
NPI:1366582876
Name:ZIA HEALTH CARE INC
Entity type:Organization
Organization Name:ZIA HEALTH CARE INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:MICHAEL
Authorized Official - Last Name:OBRIEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:575-522-5500
Mailing Address - Street 1:2001 E LOHMAN AVE
Mailing Address - Street 2:SUITE 107
Mailing Address - City:LAS CRUCES
Mailing Address - State:NM
Mailing Address - Zip Code:88001-3198
Mailing Address - Country:US
Mailing Address - Phone:575-522-5500
Mailing Address - Fax:575-647-9388
Practice Address - Street 1:2001 E LOHMAN AVE
Practice Address - Street 2:SUITE 107
Practice Address - City:LAS CRUCES
Practice Address - State:NM
Practice Address - Zip Code:88001-3198
Practice Address - Country:US
Practice Address - Phone:575-522-5500
Practice Address - Fax:575-647-9388
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-07
Last Update Date:2009-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM02473379002332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
NM000K1191Medicaid
NM000K1191Medicaid