| Pojoaque Valley High School Based Clinic | |
|
1574 State Road 502 Santa Fe NM 87506 | |
| (505) 455-4026 | |
| (575) 581-4728 |
| Full Name | Pojoaque Valley High School Based Clinic |
|---|---|
| Speciality | Clinic/Center |
| Location | 1574 State Road 502, Santa Fe, New Mexico |
| Authorized Official Name and Position | Andy R Lopez (CEO) |
| Authorized Official Contact | 5755814728 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Pojoaque Valley High School Based Clinic 571 St Rd Bldg 28 El Rito NM 87530-0237 Ph: (575) 581-4728 | Pojoaque Valley High School Based Clinic 1574 State Road 502 Santa Fe NM 87506 Ph: (505) 455-4026 |
| NPI Number | 1508035718 |
|---|---|
| Provider Enumeration Date | 02/22/2008 |
| Last Update Date | 11/04/2014 |
| Medicare PECOS PAC ID | 1456252428 |
|---|---|
| Medicare Enrollment ID | O20141215002281 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1508035718 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QS1000X | Clinic/center - Student Health | (* (Not Available)) | Primary |
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