| Grants Family Health Center | |
|
1217 Bonita St Grants NM 87020-2103 | |
| (505) 287-2958 | |
| (505) 287-2403 |
| Full Name | Grants Family Health Center |
|---|---|
| Speciality | Clinic/Center |
| Location | 1217 Bonita St, Grants, 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 |
|---|---|
| Grants Family Health Center Po Box 2267 Santa Fe NM 87504-2267 Ph: () - | Grants Family Health Center 1217 Bonita St Grants NM 87020-2103 Ph: (505) 287-2958 |
| NPI Number | 1205902376 |
|---|---|
| Provider Enumeration Date | 11/28/2006 |
| Last Update Date | 01/09/2021 |
| Medicare PECOS PAC ID | 2062324684 |
|---|---|
| Medicare Enrollment ID | O20101015000210 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1205902376 | NPI | - | NPPES |
| 43620 | Medicaid | NM | |
| 3209687 | Other | OTHER ID NUMBER |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (New Mexico) | Primary |
| 332900000X | Non-pharmacy Dispensing Site | CL00007401 (New Mexico) | Secondary |
Arnold W. Valdivia, M.d., P.c. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1208 Bonita St, Grants, NM 87020 Phone: 505-287-4474 Fax: 505-287-8775 | |
Cibola Family Health Center Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 1423 E Roosevelt Ave, Grants, NM 87020 Phone: 505-287-6500 Fax: 505-287-5393 | |
Pms/wnmmg Grants Clinic Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1217 Bonita St, Grants, NM 87020 Phone: 505-287-2950 |