| El Centro Family Health La Loma Clinic | |
|
1058 La Loma Road Anton Chico NM 87711-0070 | |
| (575) 427-5036 | |
| (575) 427-8000 |
| Full Name | El Centro Family Health La Loma Clinic |
|---|---|
| Speciality | Clinic/Center |
| Location | 1058 La Loma Road, Anton Chico, New Mexico |
| Authorized Official Name and Position | Lore Pease (CEO) |
| Authorized Official Contact | 5057537218 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| El Centro Family Health La Loma Clinic 538 N Paseo De Onate P.o. Box 158 Espanola NM 87532-2618 Ph: (505) 753-7218 | El Centro Family Health La Loma Clinic 1058 La Loma Road Anton Chico NM 87711-0070 Ph: (575) 427-5036 |
| NPI Number | 1548425234 |
|---|---|
| Provider Enumeration Date | 07/23/2008 |
| Last Update Date | 11/20/2014 |
| Medicare PECOS PAC ID | 9830080688 |
|---|---|
| Medicare Enrollment ID | O20090113000872 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1548425234 | NPI | - | NPPES |
| 1780689034 | Other | NM | ORGANIZATION NPPES |
| 47084 | Medicaid | NM |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | 6100 (New Mexico) | Primary |
Sunrise Clinics Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1753 State Hwy 119, Anton Chico, NM 87711 Phone: 575-472-4311 Fax: 877-651-0289 |