| El Centro Family Health Roy Sbhc | |
|
375 East 6th Street Roy NM 87743 | |
| (575) 485-0019 | |
| (575) 485-0020 |
| Full Name | El Centro Family Health Roy Sbhc |
|---|---|
| Speciality | Clinic/center - Federally Qualified Health Center (fqhc) |
| Location | 375 East 6th Street, Roy, New Mexico |
| Authorized Official Name and Position | Lore Pease (CEO) |
| Authorized Official Contact | 5057537218 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| El Centro Family Health Roy Sbhc 538 N Paseo De Onate P.o. Box 158 Espanola NM 87532-2618 Ph: (505) 753-7218 | El Centro Family Health Roy Sbhc 375 East 6th Street Roy NM 87743 Ph: (575) 485-0019 |
| NPI Number | 1225306525 |
|---|---|
| Provider Enumeration Date | 12/01/2011 |
| Last Update Date | 03/22/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1225306525 | NPI | - | NPPES |
| 1780689034 | Other | NM | NPPES |
| 58957553 | Medicaid | NM |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | 2015/16-19 (New Mexico) | Primary |
El Centro Family Health Roy Clinic Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 555 Wagon Mound Highway, Roy, NM 87743 Phone: 575-485-2484 Fax: 575-485-2261 |