| Mora Valley Community Health Services Inc | |
|
13 Mora Valley Clinic Road State Hwy 518 Mile Marker 26 Mora NM 87732-0209 | |
| (575) 387-5069 | |
| (575) 387-9011 |
| Full Name | Mora Valley Community Health Services Inc |
|---|---|
| Speciality | Clinic/Center |
| Location | 13 Mora Valley Clinic Road, Mora, New Mexico |
| Authorized Official Name and Position | Wanda Renay Salazar (FINANCE DIRECTOR) |
| Authorized Official Contact | 5753875069 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Mora Valley Community Health Services Inc Po Box 209 Mora NM 87732 Ph: (575) 387-5069 | Mora Valley Community Health Services Inc 13 Mora Valley Clinic Road State Hwy 518 Mile Marker 26 Mora NM 87732-0209 Ph: (575) 387-5069 |
| NPI Number | 1508840117 |
|---|---|
| Provider Enumeration Date | 12/06/2005 |
| Last Update Date | 01/21/2011 |
| Medicare PECOS PAC ID | 4486541901 |
|---|---|
| Medicare Enrollment ID | O20040301000532 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1508840117 | NPI | - | NPPES |
| 48504 | Medicaid | NM |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QC1500X | Clinic/center - Community Health | 6333 (New Mexico) | Primary |
| Provider Name | Amy G Weiss |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1871500827 PECOS PAC ID: 8224067335 Enrollment ID: I20050809000845 |
| Provider Name | Martin Ruiz |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1356410104 PECOS PAC ID: 8628070604 Enrollment ID: I20070203000093 |
| Provider Name | Jeanne M Alvarez |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1871599233 PECOS PAC ID: 4688695141 Enrollment ID: I20110721000391 |
| Provider Name | Francisco H Crespin |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1679578611 PECOS PAC ID: 1153445234 Enrollment ID: I20150911000878 |
| Provider Name | Mauricio Lopez Marquez |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1447675095 PECOS PAC ID: 2163779588 Enrollment ID: I20180717001560 |
Mora Valley Community Health Services, Inc. Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 10 Ranger Dr, Mora, NM 87732 Phone: 575-387-3117 | |
Mora Valley Community Health Services Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 3 Mora Valley Clinic Rd, Mora, NM 87732 Phone: 575-387-5069 Fax: 575-387-9011 | |
Northeast Regional Education Cooperative Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: Hwy 518 Ranger Drive, Mora, NM 87732 Phone: 505-426-2262 Fax: 505-454-1473 |