| Blue And Red Bird Corporation, Pc. | |
|
815 W 14th St Clovis NM 88101-5514 | |
| (575) 762-6492 | |
| (757) 935-8333 |
| Full Name | Blue And Red Bird Corporation, Pc. |
|---|---|
| Speciality | Clinic/center - Primary Care |
| Location | 815 W 14th St, Clovis, New Mexico |
| Authorized Official Name and Position | Ali M Ghaffari (PRESIDENT) |
| Authorized Official Contact | 5757626492 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Blue And Red Bird Corporation, Pc. 815 W 14th St Clovis NM 88101-5514 Ph: (575) 762-6492 | Blue And Red Bird Corporation, Pc. 815 W 14th St Clovis NM 88101-5514 Ph: (575) 762-6492 |
| NPI Number | 1124579958 |
|---|---|
| Provider Enumeration Date | 10/17/2016 |
| Last Update Date | 10/17/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1124579958 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | 81202 (New Mexico) | Primary |
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