| Full Name | |
|---|---|
| Speciality | Clinic/Center |
| Location | 200 W Lea St, Hobbs, 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 |
|---|---|
200 W Lea St Hobbs NM 88240-5110 Ph: (575) 391-0270 | 200 W Lea St Hobbs NM 88240-5110 Ph: (575) 391-0270 |
| NPI Number | 1093908246 |
|---|---|
| Provider Enumeration Date | 08/21/2007 |
| Last Update Date | 01/09/2021 |
| Medicare PECOS PAC ID | 2062324684 |
|---|---|
| Medicare Enrollment ID | O20070921000338 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1093908246 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
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