Individual ProviderMelissa Benvegno-ImulCase Manager/Care CoordinatorOther Service ProvidersPractice Address5601 Domingo Rd NE, Albuquerque, NM 87108-1610(505) 268-5295PECOS EnrollmentBased on the most recent information from CMS, provider Melissa Benvegno-Imul does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records yesterday at 12:57 PM.Profile DetailsProvider ID1568908838Provider TypeIndividualFull NameBenvegno-Imul, MelissaCredentialBSGenderFemaleSole ProprietorNoEnumeration Date1/11/2017Last Updated1/11/2017Contact InformationPractice LocationPractice Address5601 Domingo Rd NE, Albuquerque, NM 87108-1610Phone(505) 268-5295FaxUnlisted FaxMailing LocationMailing Address5601 Domingo Rd NE, Albuquerque, NM 87108-1610Phone(505) 268-5295FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode171M00000XPrimaryDescriptionCase Manager/Care CoordinatorOther Service ProvidersLicense01-874723-000New MexicoProvider IdentifiersIDDescriptionIssuerIDB9311DescriptionMedicaidIssuerUnlistedNew Mexico