| El Centro Family Health Roy Clinic | |
|
555 Wagon Mound Highway Roy NM 87743-0148 | |
| (575) 485-2484 | |
| (575) 485-2261 |
| Full Name | El Centro Family Health Roy Clinic |
|---|---|
| Speciality | Clinic/Center |
| Location | 555 Wagon Mound Highway, Roy, 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 Roy Clinic 538 N Paseo De Onate P.o. Box 158 Espanola NM 87532-2618 Ph: (505) 753-7218 | El Centro Family Health Roy Clinic 555 Wagon Mound Highway Roy NM 87743-0148 Ph: (575) 485-2484 |
| NPI Number | 1275798969 |
|---|---|
| Provider Enumeration Date | 07/23/2008 |
| Last Update Date | 11/21/2014 |
| Medicare PECOS PAC ID | 9830080688 |
|---|---|
| Medicare Enrollment ID | O20090113000840 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1275798969 | NPI | - | NPPES |
| 1780689034 | Other | NM | ORGANIZATION NPPES |
| 45542 | Medicaid | NM |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | 6103 (New Mexico) | Primary |
El Centro Family Health Roy Sbhc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 375 East 6th Street, Roy, NM 87743 Phone: 575-485-0019 Fax: 575-485-0020 |