| Lagom Health Llc | |
|
4123 Montgomery Blvd Ne Albuquerque NM 87109-1102 | |
| (505) 433-7745 | |
| Not Available |
| Full Name | Lagom Health Llc |
|---|---|
| Speciality | Internal Medicine |
| Location | 4123 Montgomery Blvd Ne, Albuquerque, New Mexico |
| Authorized Official Name and Position | Heather Brislen (OWNER) |
| Authorized Official Contact | 5052803126 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Lagom Health Llc 4123 Montgomery Blvd Ne Albuquerque NM 87109-1102 Ph: (505) 280-3126 | Lagom Health Llc 4123 Montgomery Blvd Ne Albuquerque NM 87109-1102 Ph: (505) 433-7745 |
| NPI Number | 1174975791 |
|---|---|
| Provider Enumeration Date | 07/07/2016 |
| Last Update Date | 03/05/2020 |
| Medicare PECOS PAC ID | 9335434612 |
|---|---|
| Medicare Enrollment ID | O20160825001486 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1174975791 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | MD2011-0202 (New Mexico) | Primary |
| Provider Name | Percy Pentecost |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1750377412 PECOS PAC ID: 5496799892 Enrollment ID: I20050815000328 |
| Provider Name | Heather C Brislen |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1891991121 PECOS PAC ID: 7911222013 Enrollment ID: I20150212001435 |
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