| El Centro Family Health Rhs Sbhc | |
|
1236 5th St Las Vegas NM 87701-4337 | |
| (505) 454-2737 | |
| Not Available |
| Full Name | El Centro Family Health Rhs Sbhc |
|---|---|
| Speciality | Clinic/Center |
| Location | 1236 5th St, Las Vegas, 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 Rhs Sbhc 538 N Paseo De Onate P.o. Box 158 Espanola NM 87532-2618 Ph: (505) 753-7218 | El Centro Family Health Rhs Sbhc 1236 5th St Las Vegas NM 87701-4337 Ph: (505) 454-2737 |
| NPI Number | 1902208234 |
|---|---|
| Provider Enumeration Date | 09/18/2014 |
| Last Update Date | 06/07/2023 |
| Medicare PECOS PAC ID | 9830080688 |
|---|---|
| Medicare Enrollment ID | O20170531000888 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1902208234 | NPI | - | NPPES |
| 1780689034 | Other | NM | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | 3393 (New Mexico) | Secondary |
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
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