| El Centro Family Health Embudo Clinic | |
|
Hwy 68 #2243 Rinconada Embudo NM 87531-2627 | |
| (505) 579-4255 | |
| (505) 579-4669 |
| Full Name | El Centro Family Health Embudo Clinic |
|---|---|
| Speciality | Clinic/Center |
| Location | Hwy 68 #2243 Rinconada, Embudo, New Mexico |
| Authorized Official Name and Position | Lore Pease (CEO) |
| Authorized Official Contact | 5057537218 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| El Centro Family Health Embudo Clinic 538 N Paseo De Onate P.o. Box 158 Espanola NM 87532-2618 Ph: (505) 753-7218 | El Centro Family Health Embudo Clinic Hwy 68 #2243 Rinconada Embudo NM 87531-2627 Ph: (505) 579-4255 |
| NPI Number | 1407011315 |
|---|---|
| Provider Enumeration Date | 07/21/2008 |
| Last Update Date | 03/04/2015 |
| Medicare PECOS PAC ID | 9830080688 |
|---|---|
| Medicare Enrollment ID | O20090113000901 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1407011315 | NPI | - | NPPES |
| 1780689034 | Other | NM | ORGANIZATION NPPES |
| 47498 | Medicaid | NM |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | 6003 (New Mexico) | Primary |