Compassion Care Clinic Pc | |
600 Hwy 195 Ste A Elephant Butte NM 87935 | |
(575) 744-4872 | |
Not Available |
Full Name | Compassion Care Clinic Pc |
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Speciality | Family Medicine |
Location | 600 Hwy 195, Elephant Butte, New Mexico |
Authorized Official Name and Position | Dallas Lipscomb (OWNER) |
Authorized Official Contact | 5757444872 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Compassion Care Clinic Pc Po Box 449 Elephant Butte NM 87935-0449 Ph: (575) 744-4872 | Compassion Care Clinic Pc 600 Hwy 195 Ste A Elephant Butte NM 87935 Ph: (575) 744-4872 |
NPI Number | 1063027761 |
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Provider Enumeration Date | 09/10/2020 |
Last Update Date | 09/10/2020 |
Medicare PECOS PAC ID | 9537589775 |
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Medicare Enrollment ID | O20201009000124 |
Identifier | Type | State | Issuer |
---|---|---|---|
1063027761 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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207Q00000X | Family Medicine | (* (Not Available)) | Primary |
Provider Name | Chandran Vedamanikam |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1154585990 PECOS PAC ID: 4587838784 Enrollment ID: I20111128000789 |
Provider Name | Kimberly A Hill |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1861961930 PECOS PAC ID: 3678815677 Enrollment ID: I20190423001093 |
Elephant Butte Clinic Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 600 Butte Blvd, Elephant Butte, NM 87935 Phone: 575-894-3221 |