| St. Christopher Inc | |
|
2800 San Mateo Blvd Ne Suite 107 Albuquerque NM 87110-3135 | |
| (505) 821-1146 | |
| (505) 843-9234 |
| Full Name | St. Christopher Inc |
|---|---|
| Speciality | Clinic/Center |
| Location | 2800 San Mateo Blvd Ne, Albuquerque, New Mexico |
| Authorized Official Name and Position | Peter K Tiernan (PRESIDENT) |
| Authorized Official Contact | 5058211146 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| St. Christopher Inc 2800 San Mateo Blvd Ne Suite 107 Albuquerque NM 87110-3135 Ph: (505) 821-1146 | St. Christopher Inc 2800 San Mateo Blvd Ne Suite 107 Albuquerque NM 87110-3135 Ph: (505) 821-1146 |
| NPI Number | 1356405369 |
|---|---|
| Provider Enumeration Date | 12/21/2006 |
| Last Update Date | 08/21/2010 |
| Medicare PECOS PAC ID | 3870595879 |
|---|---|
| Medicare Enrollment ID | O20070205000158 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1356405369 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | 03079971006 (New Mexico) | Primary |
| Provider Name | Peter K Tiernan |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1902819550 PECOS PAC ID: 1759386485 Enrollment ID: I20061104000042 |
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