VIP STARNETWORK, LLC (NPI# 1104442698) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1104442698 |
| Entity Type | Organization |
| Organization Name | VIP STARNETWORK, LLC |
| Practice Address |
4904 Alameda Blvd Ne Ste B Albuquerque NM 87113-2385 |
| Mailing Address |
Po Box 90056 Albuquerque NM 87199-0056 |
| Practice Telephone | 5053892279 |
| Practice Fax Number | 5052120553 |
| Mailing Telephone | 5053892279 |
| Mailing Fax Number | 5052120553 |
| Enumeration Date | 2020-06-19 |
| Last Update Date | 2020-06-19 |
| Authorized Official Name | JOHONNIUSS H CHEMWENO (CEO) |
| Authorized Official Telephone | 5053892279 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 251X00000X | Supports Brokerage | Agencies | ||
| N | 261QH0100X |
Clinic/Center Specialization: Health Service |
Ambulatory Health Care Facilities | ||
| N | 251G00000X | Hospice Care, Community Based | Agencies | ||
| N | 251K00000X | Public Health or Welfare | Agencies | ||
| Y | 261QM2500X |
Clinic/Center Specialization: Medical Specialty |
Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| VIP STARNETWORK, LLC | Former Legal Business Name - Organization |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| New York State Corporations | VIP STARNETWORK, LLC | 4904 Alameda Blvd. Ne., Ste. B, Albuquerque, New Mexico 87113 |
| Street Address |
4904 ALAMEDA BLVD NE STE B |
| City | ALBUQUERQUE |
| State | NM |
| Zip Code | 87113-2385 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952786386 | Inverse Medical, LLC | Supports Brokerage | 4904 Alameda Blvd Ne Ste B, Albuquerque, NM 87113-2385 | 2015-07-27 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952944613 | Wendy Valenciano Flores | Behavior Technician | 9019 Washington St Ne Building A, Albuquerque, NM 87113 | 2019-10-24 |
| 1336608504 | Southwestern Provider Services LLC | Registered Nurse | 6400 Paseo Del Norte, Albuquerque, NM 87113 | 2019-03-18 |
| 1376047795 | Anne K. Hempstead D.d.s., P.C. | Dentist | 6400 Holly Ave Ne Ste M, Albuquerque, NM 87113 | 2018-03-20 |
| 1447769518 | Ethan Grant | Behavior Technician | 8500 Washington St Ste A1, Albuquerque, NM 87113 | 2017-09-21 |
| 1215451083 | Sarah Bartlett | Behavior Technician | 8500 Washington St, Ste A1, Albuquerque, NM 87113 | 2017-08-02 |
| 1396109906 | Cathy A Walters | Specialist/Technologist | 532 Osuna Rd Ne, Albuquerque, NM 87113 | 2016-04-09 |
| 1518389824 | Esther Sanchez | Home Health Aide | 6800 Vista Del Norte Drive, 2814, Albuqerque, NM 87113 | 2014-01-07 |
| 1356775456 | Danielle Juliet Fichera | Social Worker | 315 Alameda Park Dr, Ne, Albuquerque, NM 87113 | 2013-08-26 |
| 1093053340 | Eagle Pointe Dentists and Orthodontics, LLC | Dentist | 6230 Paseo Del Norte Ne, Suite B, Albuquerque, NM 87113 | 2013-01-22 |
| 1922346428 | Keith Levitt | Anesthesiology | 8100 Wyoming Blvd Ne #712, Suite M4, Albuquerque, NM 87113 | 2013-01-18 |
| Find all providers in zip 87113 | ||||
| Taxonomy Code | 261QM2500X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Medical Specialty |
| An entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to a specific area of medical specialization. Frequently used for Title V related Children's Specialty services or to meet specific public health needs (e.g., infectious diseases or breast and cervical cancer). |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013367440 | Caperton Fertility Institute, LLC | Clinic/Center | 6500 Jefferson St Ne Ste 250, Albuquerque, NM 87109-3490 | 2016-06-16 |
| 1033599741 | Power of Touch Massage Therapy | Clinic/Center | 5353 Wyoming Blvd Ne Ste C, Albuquerque, NM 87109 | 2015-06-08 |
| 1740620327 | Contact Lens Gallery, Inc. | Clinic/Center | 6321 Riverside Plaza Ln Nw Ste B, Albuquerque, NM 87120-2641 | 2013-06-27 |
| 1356780597 | Health Quest Albuquerque Acres LLC | Clinic/Center | 8650 Alameda Blvd Ne, Suite 104e, Albuquerque, NM 87122-3744 | 2013-06-20 |
| 1275801359 | Visionquest I-rx Inc | Clinic/Center | 2501 Yale Blvd Se Ste 301, Albuquerque, NM 87106-4358 | 2011-12-05 |
| 1427387836 | Francesco Standoli Md, LLC | Clinic/Center | 9207 Snowridge Ct Ne, Albuquerque, NM 87111-2440 | 2009-12-14 |
| 1871947861 | Luis Cuadros Md LLC | Clinic/Center | 8232 Louisiana Blvd Ne Ste A, Albuquerque, NM 87113-2429 | 2016-04-16 |
| 1538573027 | Sol State Massage | Clinic/Center | 5353 Wyoming Blvd Ne, Suite C, Albuquerque, NM 87109 | 2014-06-12 |
| 1457788317 | Health Quest Wellness Journal Center LLC | Clinic/Center | 3824 Masthead St Ne, Albuquerque, NM 87109-4479 | 2013-10-08 |
| 1750688032 | Rio Grande Internal Medicine PC | Clinic/Center | 4801 Mcmahon Blvd Nw, Suite 235, Albuquerque, NM 87114-5090 | 2011-02-22 |
| Find all providers in ALBUQUERQUE | ||||
| City | ALBUQUERQUE |
| Zip Code | 87113 |
Please comment or provide details below to improve the information on VIP STARNETWORK, LLC.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.