Red River Primary Care | |
200 A Pioneer Road Red River NM 87558-0000 | |
(575) 754-1773 | |
(505) 989-3536 |
Full Name | Red River Primary Care |
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Speciality | General Practice |
Location | 200 A Pioneer Road, Red River, New Mexico |
Authorized Official Name and Position | Lesa D Fraker (PRESIDENT) |
Authorized Official Contact | 5059898707 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Red River Primary Care 707 Paseo De Peralta Santa Fe NM 87501-1922 Ph: (505) 989-8707 | Red River Primary Care 200 A Pioneer Road Red River NM 87558-0000 Ph: (575) 754-1773 |
NPI Number | 1053672485 |
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Provider Enumeration Date | 06/01/2012 |
Last Update Date | 06/01/2012 |
Identifier | Type | State | Issuer |
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1053672485 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
208D00000X | General Practice | (* (Not Available)) | Primary |
Main Street Medical Center, Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 200 Pioneer Rd, Ste A, Red River, NM 87558 Phone: 575-754-6330 Fax: 575-754-6232 |