| Las Vegas Stat Care Inc. | |
|
260 Mills Ave Las Vegas NM 87701-4125 | |
| (505) 425-6283 | |
| (505) 425-7196 |
| Full Name | Las Vegas Stat Care Inc. |
|---|---|
| Speciality | General Practice |
| Location | 260 Mills Ave, Las Vegas, New Mexico |
| Authorized Official Name and Position | M. Eileen Madrid (BOARD PRESIDENT) |
| Authorized Official Contact | 5054547945 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Las Vegas Stat Care Inc. Po Box 2545 Las Vegas NM 87701-2545 Ph: (505) 454-7945 | Las Vegas Stat Care Inc. 260 Mills Ave Las Vegas NM 87701-4125 Ph: (505) 425-6283 |
| NPI Number | 1730194499 |
|---|---|
| Provider Enumeration Date | 07/30/2006 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1730194499 | NPI | - | NPPES |
| 51932253 | Medicaid | NM |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208D00000X | General Practice | (New Mexico) | Primary |
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