| Esperanza Family Health Center | |
|
903 C N 5th St Estancia NM 87016 | |
| (505) 384-2777 | |
| (505) 384-2204 |
| Full Name | Esperanza Family Health Center |
|---|---|
| Speciality | Clinic/Center |
| Location | 903 C N 5th St, Estancia, New Mexico |
| Authorized Official Name and Position | Roberta Lee (CFO) |
| Authorized Official Contact | 5059825565 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Esperanza Family Health Center Po Box 2267 Santa Fe NM 87504-2267 Ph: () - | Esperanza Family Health Center 903 C N 5th St Estancia NM 87016 Ph: (505) 384-2777 |
| NPI Number | 1912016734 |
|---|---|
| Provider Enumeration Date | 08/29/2006 |
| Last Update Date | 01/23/2014 |
| Medicare PECOS PAC ID | 2062324684 |
|---|---|
| Medicare Enrollment ID | O20110204000051 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1912016734 | NPI | - | NPPES |
| 48058 | Medicaid | NM | |
| 3209790 | Other | OTHER ID NUMBER |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | 6348 (New Mexico) | Primary |
| 332900000X | Non-pharmacy Dispensing Site | CL00007280 (New Mexico) | Secondary |