| Centennial School Base | |
|
1950 Sonoma Ranch Blvd. Las Cruces NM 88011 | |
| (575) 525-4811 | |
| (575) 524-4266 |
| Full Name | Centennial School Base |
|---|---|
| Speciality | Clinic/Center |
| Location | 1950 Sonoma Ranch Blvd., Las Cruces, New Mexico |
| Authorized Official Name and Position | Virgil Medina (CEO) |
| Authorized Official Contact | 5755261105 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Centennial School Base 385 Calle De Alegra Bldg A Las Cruces NM 88005-3423 Ph: (575) 526-1105 | Centennial School Base 1950 Sonoma Ranch Blvd. Las Cruces NM 88011 Ph: (575) 525-4811 |
| NPI Number | 1639553928 |
|---|---|
| Provider Enumeration Date | 07/16/2015 |
| Last Update Date | 05/13/2021 |
| Certification Date | 05/13/2021 |
| Medicare PECOS PAC ID | 6305745191 |
|---|---|
| Medicare Enrollment ID | O20160728001217 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1639553928 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | () | Primary |
Southwest Center on Aging Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 1106 Centre Ct, Las Cruces, NM 88011 Phone: 575-532-5455 Fax: 575-532-5641 |
Memorial Medical Center Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 2450 S Telshor Blvd, Las Cruces, NM 88011 Phone: 575-521-5385 |
Harry Bass, M.D., P.A. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 2425 S Telshor Blvd, Las Cruces, NM 88011 Phone: 575-522-0330 Fax: 575-522-8620 |
Memorial Medical Center Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 2450 S Telshor Blvd, Las Cruces, NM 88011 Phone: 575-521-5385 |
Rhsnm Physician Group Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 4441 E Lohman Ave, Las Cruces, NM 88011 Phone: 575-521-6400 |
Smart Care, Inc. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 2801 Missouri Ave Ste 12, Las Cruces, NM 88011 Phone: 575-522-6900 Fax: 575-522-8891 |