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1105 Memorial Dr Artesia NM 88210-1189 | |
(575) 746-9848 | |
(575) 746-9840 |
Full Name | |
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Speciality | Clinic/Center |
Location | 1105 Memorial Dr, Artesia, New Mexico |
Authorized Official Name and Position | Marc Welch (VP OF FINANCE) |
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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Po Box 2267 Santa Fe NM 87504-2267 Ph: () - | 1105 Memorial Dr Artesia NM 88210-1189 Ph: (575) 746-9848 |
NPI Number | 1841302395 |
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Provider Enumeration Date | 08/31/2006 |
Last Update Date | 07/21/2022 |
Medicare PECOS PAC ID | 2062324684 |
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Medicare Enrollment ID | O20110216000768 |
Identifier | Type | State | Issuer |
---|---|---|---|
1841302395 | NPI | - | NPPES |
3209663 | Other | OTHER ID NUMBER | |
F4902 | Medicaid | NM |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (New Mexico) | Primary |
332900000X | Non-pharmacy Dispensing Site | CL00007437 (New Mexico) | Secondary |
Zencare Family Wellness Llc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 301 S Roselawn Ave, Artesia, NM 88210 Phone: 575-746-3616 Fax: 575-748-2544 | |
Proactive Md Nm, Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1107 E. Main St., Artesia, NM 88210 Phone: 864-501-0751 | |