| Palo Verde Family Care, Inc. | |
|
108 South Broad St. Globe AZ 85501 | |
| (928) 425-6592 | |
| (928) 425-7566 |
| Full Name | Palo Verde Family Care, Inc. |
|---|---|
| Speciality | Family Medicine |
| Location | 108 South Broad St., Globe, Arizona |
| Authorized Official Name and Position | Oscar Ernesto Andrade (PRESIDENT) |
| Authorized Official Contact | 9284020952 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Palo Verde Family Care, Inc. Po Box 1508 Claypool AZ 85539 Ph: (928) 402-0952 | Palo Verde Family Care, Inc. 108 South Broad St. Globe AZ 85501 Ph: (928) 425-6592 |
| NPI Number | 1205962792 |
|---|---|
| Provider Enumeration Date | 02/26/2007 |
| Last Update Date | 10/19/2015 |
| Medicare PECOS PAC ID | 2668434150 |
|---|---|
| Medicare Enrollment ID | O20041027000924 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1205962792 | NPI | - | NPPES |
| 1225107667 | Other | AZ | SHERIDA CARLSON PA NPI |
| 475592 | Medicaid | AZ | |
| 1871545905 | Other | AZ | JEAN TURNEY-SHAW FPN NPI |
| 1275685521 | Other | AZ | AZ NPI OSCAR ERNEST ANDRA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 27758 (Arizona) | Primary |
| Provider Name | Oscar E Andrade |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1275685521 PECOS PAC ID: 0345232757 Enrollment ID: I20040402000852 |
| Provider Name | Richard A Melde |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1710027438 PECOS PAC ID: 9436134608 Enrollment ID: I20040722001342 |
| Provider Name | Tina L Mugford |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1992154348 PECOS PAC ID: 5698068799 Enrollment ID: I20160727001232 |
| Provider Name | Susan Lynn Robertson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1396323689 PECOS PAC ID: 8527082460 Enrollment ID: I20210527001648 |
| Provider Name | Ashley Brooke Bravo |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1922792191 PECOS PAC ID: 3173977014 Enrollment ID: I20230927001189 |
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