| Mountain Sage Medico | |
|
1660 Old Pecos Trl Ste F Santa Fe NM 87505-4768 | |
| (505) 472-7243 | |
| (505) 472-7244 |
| Full Name | Mountain Sage Medico |
|---|---|
| Speciality | Internal Medicine |
| Location | 1660 Old Pecos Trl Ste F, Santa Fe, New Mexico |
| Authorized Official Name and Position | Susan Barrett (OWNER) |
| Authorized Official Contact | 5054727243 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Mountain Sage Medico 1660 Old Pecos Trl Ste F Santa Fe NM 87505-4768 Ph: (505) 472-7243 | Mountain Sage Medico 1660 Old Pecos Trl Ste F Santa Fe NM 87505-4768 Ph: (505) 472-7243 |
| NPI Number | 1326777418 |
|---|---|
| Provider Enumeration Date | 06/06/2022 |
| Last Update Date | 09/29/2023 |
| Medicare PECOS PAC ID | 0840670931 |
|---|---|
| Medicare Enrollment ID | O20220707000709 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1326777418 | NPI | - | NPPES |
| Provider Name | Joseph Poole |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1457712549 PECOS PAC ID: 9739473521 Enrollment ID: I20190809001589 |
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