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2573 State Hwy 522 Questa NM 87556 | |
| (575) 586-0315 | |
| (575) 586-0519 |
| Full Name | |
|---|---|
| Speciality | Clinic/Center |
| Location | 2573 State Hwy 522, Questa, New Mexico |
| Authorized Official Name and Position | Doug Smith (EXECUTIVE VICE PRESIDENT) |
| Authorized Official Contact | 5059825565 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
Po Box 2267 Santa Fe NM 87504-2267 Ph: () - | 2573 State Hwy 522 Questa NM 87556 Ph: (575) 586-0315 |
| NPI Number | 1588731582 |
|---|---|
| Provider Enumeration Date | 11/29/2006 |
| Last Update Date | 01/09/2021 |
| Medicare PECOS PAC ID | 2062324684 |
|---|---|
| Medicare Enrollment ID | O20101015000575 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1588731582 | NPI | - | NPPES |
| 3209586 | Other | OTHER ID NUMBER | |
| 47225 | Medicaid | NM |