Oak Street Clinic | |
200 Oak St Ne Suite 2 Albuquerque NM 87106-4740 | |
(505) 508-0197 | |
(505) 508-0465 |
Full Name | Oak Street Clinic |
---|---|
Speciality | Clinic/center - Primary Care |
Location | 200 Oak St Ne, Albuquerque, New Mexico |
Authorized Official Name and Position | Jason Deluisa (OWNER) |
Authorized Official Contact | 5053310295 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
Oak Street Clinic Po Box 25744 Albuquerque NM 87125-0744 Ph: (505) 508-0197 | Oak Street Clinic 200 Oak St Ne Suite 2 Albuquerque NM 87106-4740 Ph: (505) 508-0197 |
NPI Number | 1801100466 |
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Provider Enumeration Date | 08/05/2010 |
Last Update Date | 02/06/2015 |
Identifier | Type | State | Issuer |
---|---|---|---|
1801100466 | NPI | - | NPPES |
Q7732 | Medicaid | NM | |
21253790 | Medicaid | NM | |
77304853 | Medicaid | NM | |
10326855 | Medicaid | NM | |
37805771 | Medicaid | NM |
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