| Medmark Treatment Centers Isleta | |
|
901 3rd St Nw Albuquerque NM 87102-2235 | |
| (505) 717-2397 | |
| Not Available |
| Full Name | Medmark Treatment Centers Isleta |
|---|---|
| Speciality | Family Medicine |
| Location | 901 3rd St Nw, Albuquerque, New Mexico |
| Authorized Official Name and Position | Bruce Jarvie (VP, TREASURER) |
| Authorized Official Contact | 2143793300 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Medmark Treatment Centers Isleta 1720 Lakepointe Dr Ste 117 Lewisville TX 75057-6425 Ph: (214) 379-3300 | Medmark Treatment Centers Isleta 901 3rd St Nw Albuquerque NM 87102-2235 Ph: (505) 717-2397 |
| NPI Number | 1861848632 |
|---|---|
| Provider Enumeration Date | 05/10/2016 |
| Last Update Date | 07/29/2024 |
| Certification Date | 07/29/2024 |
| Medicare PECOS PAC ID | 1951665496 |
|---|---|
| Medicare Enrollment ID | O20180508002658 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1861848632 | NPI | - | NPPES |
| Provider Name | Sergio A Huerta |
|---|---|
| Provider Type | Practitioner - Addiction Medicine |
| Provider Identifiers | NPI Number: 1891085882 PECOS PAC ID: 8820222938 Enrollment ID: I20141011000156 |
| Provider Name | Paul E Romo |
|---|---|
| Provider Type | Practitioner - Addiction Medicine |
| Provider Identifiers | NPI Number: 1306089313 PECOS PAC ID: 2062649007 Enrollment ID: I20141014000472 |
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