| Holy Cross Hospital Penasco Clinic | |
|
#24 Highway 73 Penasco NM 87553-0205 | |
| (575) 587-1833 | |
| (575) 587-1918 |
| Full Name | Holy Cross Hospital Penasco Clinic |
|---|---|
| Speciality | Clinic/center - Community Health |
| Location | #24 Highway 73, Penasco, New Mexico |
| Authorized Official Name and Position | Patrick E Rose (SPECIAL PROJECTS) |
| Authorized Official Contact | 5757518905 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Holy Cross Hospital Penasco Clinic 1397 Weimer Rd Taos NM 87571-6253 Ph: (575) 751-8905 | Holy Cross Hospital Penasco Clinic #24 Highway 73 Penasco NM 87553-0205 Ph: (575) 587-1833 |
| NPI Number | 1669521282 |
|---|---|
| Provider Enumeration Date | 01/10/2007 |
| Last Update Date | 04/19/2011 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1669521282 | NPI | - | NPPES |
| S5239 | Medicaid | NM |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QC1500X | Clinic/center - Community Health | (* (Not Available)) | Primary |
El Centro Family Health Penasco Clinic Primary Care Clinic Medicare: Medicare Enrolled Practice Location: State Road 75 #15136, Penasco, NM 87553 Phone: 575-587-2205 Fax: 575-587-1944 | |
El Centro Family Health Psbhc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 14190 State Road 75, Penasco, NM 87553 Phone: 575-587-2623 Fax: 575-587-2317 |