| Oak Street Clinic | |
|
200 Oak St Ne Suite 2 Albuquerque NM 87106-4740 | |
| (505) 508-0197 | |
| (505) 508-0465 |
| Full Name | Oak Street Clinic |
|---|---|
| Speciality | Clinic/center - Primary Care |
| Location | 200 Oak St Ne, Albuquerque, New Mexico |
| Authorized Official Name and Position | Jason Deluisa (OWNER) |
| Authorized Official Contact | 5053310295 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Oak Street Clinic Po Box 25744 Albuquerque NM 87125-0744 Ph: (505) 508-0197 | Oak Street Clinic 200 Oak St Ne Suite 2 Albuquerque NM 87106-4740 Ph: (505) 508-0197 |
| NPI Number | 1801100466 |
|---|---|
| Provider Enumeration Date | 08/05/2010 |
| Last Update Date | 02/06/2015 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1801100466 | NPI | - | NPPES |
| Q7732 | Medicaid | NM | |
| 21253790 | Medicaid | NM | |
| 77304853 | Medicaid | NM | |
| 10326855 | Medicaid | NM | |
| 37805771 | Medicaid | NM |
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