Full Name | |
---|---|
Speciality | Clinic/center - Federally Qualified Health Center (fqhc) |
Location | 121 N Main St, Melrose, New Mexico |
Authorized Official Name and Position | Seferino M Montano (CEO) |
Authorized Official Contact | 5753566695 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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121 Main St Melrose NM 88124-9680 Ph: (575) 253-4212 | 121 N Main St Melrose NM 88124 Ph: (575) 253-4212 |
NPI Number | 1790072478 |
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Provider Enumeration Date | 07/01/2011 |
Last Update Date | 03/01/2012 |
Identifier | Type | State | Issuer |
---|---|---|---|
1790072478 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |