Counselor Navajo Clinic | |
9837 Us Highway 550 Counselor NM 87018 | |
(505) 568-4328 | |
(505) 568-4308 |
Full Name | Counselor Navajo Clinic |
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Speciality | Clinic/Center |
Location | 9837 Us Highway 550, Counselor, 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 |
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Counselor Navajo Clinic Po Box 2267 Santa Fe NM 87504-2267 Ph: () - | Counselor Navajo Clinic 9837 Us Highway 550 Counselor NM 87018 Ph: (505) 568-4328 |
NPI Number | 1396824223 |
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Provider Enumeration Date | 11/02/2006 |
Last Update Date | 01/09/2021 |
Medicare PECOS PAC ID | 2062324684 |
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Medicare Enrollment ID | O20110216000888 |
Identifier | Type | State | Issuer |
---|---|---|---|
1396824223 | NPI | - | NPPES |
48322 | Medicaid | NM | |
3209550 | Other | OTHER ID NUMBER |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | 6611 (New Mexico) | Primary |
332900000X | Non-pharmacy Dispensing Site | CL00007156 (New Mexico) | Secondary |