San Jon School Based Health Center | |
7th And Elm Street San Jon NM 88434 | |
(575) 576-2273 | |
(575) 576-2273 |
Full Name | San Jon School Based Health Center |
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Speciality | Clinic/center - Federally Qualified Health Center (fqhc) |
Location | 7th And Elm Street, San Jon, New Mexico |
Authorized Official Name and Position | Gary Salazar (SUPERINTENDENT OF SCHOOLS) |
Authorized Official Contact | 5755762467 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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San Jon School Based Health Center Po Box 5 San Jon NM 88434-0005 Ph: (575) 576-2273 | San Jon School Based Health Center 7th And Elm Street San Jon NM 88434 Ph: (575) 576-2273 |
NPI Number | 1275836231 |
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Provider Enumeration Date | 12/14/2010 |
Last Update Date | 12/14/2010 |
Identifier | Type | State | Issuer |
---|---|---|---|
1275836231 | NPI | - | NPPES |
1E03 | Medicaid | NM |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (New Mexico) | Primary |