Ortiz Mountain Health Center | |
06b Main St Cerrillos NM 87010 | |
(505) 470-6266 | |
(505) 471-5861 |
Full Name | Ortiz Mountain Health Center |
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Speciality | Clinic/Center |
Location | 06b Main St, Cerrillos, New Mexico |
Authorized Official Name and Position | Roberta Lee (CFO) |
Authorized Official Contact | 5059825565 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Ortiz Mountain Health Center Po Box 2267 Santa Fe NM 87504-2267 Ph: () - | Ortiz Mountain Health Center 06b Main St Cerrillos NM 87010 Ph: (505) 470-6266 |
NPI Number | 1811064827 |
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Provider Enumeration Date | 11/29/2006 |
Last Update Date | 11/02/2011 |
Medicare PECOS PAC ID | 2062324684 |
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Medicare Enrollment ID | O20100809000645 |
Identifier | Type | State | Issuer |
---|---|---|---|
1811064827 | NPI | - | NPPES |
3209803 | Other | OTHER ID NUMBER | |
F4919 | Medicaid | NM |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | 6515 (New Mexico) | Primary |
332900000X | Non-pharmacy Dispensing Site | CL00007440 (New Mexico) | Secondary |