Provider Demographics
NPI:1194975847
Name:FABRION OF NM D/B/A RIO GRANDE ERRANDS
Entity type:Organization
Organization Name:FABRION OF NM D/B/A RIO GRANDE ERRANDS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:EARLE
Authorized Official - Middle Name:
Authorized Official - Last Name:BOYER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:505-832-9496
Mailing Address - Street 1:PO BOX 2764
Mailing Address - Street 2:
Mailing Address - City:MORIARTY
Mailing Address - State:NM
Mailing Address - Zip Code:87035-2764
Mailing Address - Country:US
Mailing Address - Phone:505-832-9496
Mailing Address - Fax:
Practice Address - Street 1:201 ELM ST
Practice Address - Street 2:
Practice Address - City:MAGDALENA
Practice Address - State:NM
Practice Address - Zip Code:87825
Practice Address - Country:US
Practice Address - Phone:505-832-9496
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-09-30
Last Update Date:2008-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes347C00000XTransportation ServicesPrivate Vehicle