Kolomeir Clinic, Llc | |
5345 Wyoming Blvd Suite 101 Albuquerque NM 87109-3193 | |
(505) 856-6898 | |
(505) 292-1574 |
Full Name | Kolomeir Clinic, Llc |
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Speciality | Clinic/Center |
Location | 5345 Wyoming Blvd, Albuquerque, New Mexico |
Authorized Official Name and Position | Maureen Kolomeir (NURSE PRACTITIONER OWNER) |
Authorized Official Contact | 5057203819 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Kolomeir Clinic, Llc 8205 Spain Rd Ne Suite 106 Albuquerque NM 87109-3155 Ph: (505) 384-7352 | Kolomeir Clinic, Llc 5345 Wyoming Blvd Suite 101 Albuquerque NM 87109-3193 Ph: (505) 856-6898 |
NPI Number | 1982995205 |
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Provider Enumeration Date | 04/20/2011 |
Last Update Date | 01/28/2014 |
Medicare PECOS PAC ID | 4789809740 |
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Medicare Enrollment ID | O20140707001267 |
Identifier | Type | State | Issuer |
---|---|---|---|
1982995205 | NPI | - | NPPES |
84887231 | Medicaid | NM |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QM0850X | Clinic/center - Adult Mental Health | (* (Not Available)) | Primary |
Provider Name | Maureen R. Kolomeir |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1003148156 PECOS PAC ID: 2062542897 Enrollment ID: I20100604000820 |
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