| Supam Llc | |
|
5419 North Lovington Highway Suite 7 Hobbs NM 88240-9135 | |
| (575) 392-3903 | |
| (575) 392-3911 |
| Full Name | Supam Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 5419 North Lovington Highway, Hobbs, New Mexico |
| Authorized Official Name and Position | Mukeshbhai B Patel (OWNER) |
| Authorized Official Contact | 7327132824 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Supam Llc 5419 N Lovington Hwy Suite 7 Hobbs NM 88240-9100 Ph: (575) 392-3903 | Supam Llc 5419 North Lovington Highway Suite 7 Hobbs NM 88240-9135 Ph: (575) 392-3903 |
| NPI Number | 1104118884 |
|---|---|
| Provider Enumeration Date | 05/12/2011 |
| Last Update Date | 03/01/2012 |
| Medicare PECOS PAC ID | 2163692955 |
|---|---|
| Medicare Enrollment ID | O20120305000136 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1104118884 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | (* (Not Available)) | Primary |
| Provider Name | Mukeshbhai B Patel |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1639276934 PECOS PAC ID: 2365413606 Enrollment ID: I20120305000216 |
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