| Desert Wolf Healthcare Llc | |
|
2509 Virginia St Ne Ste B Albuquerque NM 87110-4695 | |
| (505) 318-0717 | |
| (505) 349-0803 |
| Full Name | Desert Wolf Healthcare Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 2509 Virginia St Ne Ste B, Albuquerque, New Mexico |
| Authorized Official Name and Position | Christopher Steven Myers (PHYSICIAN) |
| Authorized Official Contact | 5053180717 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Desert Wolf Healthcare Llc 1510 Windmill Ct Nw Albuquerque NM 87114-5605 Ph: (505) 459-7637 | Desert Wolf Healthcare Llc 2509 Virginia St Ne Ste B Albuquerque NM 87110-4695 Ph: (505) 318-0717 |
| NPI Number | 1366264111 |
|---|---|
| Provider Enumeration Date | 10/31/2024 |
| Last Update Date | 11/12/2024 |
| Medicare PECOS PAC ID | 8022546845 |
|---|---|
| Medicare Enrollment ID | O20250107003800 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1366264111 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Primary |
| Provider Name | Christopher S Myers |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1982014718 PECOS PAC ID: 5092094086 Enrollment ID: I20171011001345 |
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