| Lancer Health Group, Llc | |
|
1400 S 2nd St Raton NM 87740-2102 | |
| (505) 400-5491 | |
| Not Available |
| Full Name | Lancer Health Group, Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 1400 S 2nd St, Raton, New Mexico |
| Authorized Official Name and Position | Marcia Hefker (OWNER/PRACTITIONER) |
| Authorized Official Contact | 5053981567 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Lancer Health Group, Llc Po Box 8 Raton NM 87740-0008 Ph: (505) 400-5491 | Lancer Health Group, Llc 1400 S 2nd St Raton NM 87740-2102 Ph: (505) 400-5491 |
| NPI Number | 1700345436 |
|---|---|
| Provider Enumeration Date | 03/12/2019 |
| Last Update Date | 04/01/2021 |
| Medicare PECOS PAC ID | 1052646841 |
|---|---|
| Medicare Enrollment ID | O20190716003336 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1700345436 | NPI | - | NPPES |
| PENDING | Medicaid | NM |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM1300X | Clinic/center - Multi-specialty | (* (Not Available)) | Primary |
| Provider Name | Marcia L Hefker |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1609873355 PECOS PAC ID: 7315049467 Enrollment ID: I20070221000149 |
| Provider Name | Lydia Hernandez |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1871933721 PECOS PAC ID: 4981939550 Enrollment ID: I20190718002443 |
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