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1775 Hopewell St Santa Fe NM 87505-3896 | |
(054) 443-3100 | |
(505) 989-5368 |
Full Name | |
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Speciality | Clinic/Center |
Location | 1775 Hopewell St, Santa Fe, New Mexico |
Authorized Official Name and Position | Doug Smith (EXECUTIVE VICE PRESIDENT) |
Authorized Official Contact | 5059825565 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Po Box 2267 Santa Fe NM 87504-2267 Ph: (505) 982-5565 | 1775 Hopewell St Santa Fe NM 87505-3896 Ph: (054) 443-3100 |
NPI Number | 1841881117 |
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Provider Enumeration Date | 01/29/2021 |
Last Update Date | 04/07/2022 |
Medicare PECOS PAC ID | 2062324684 |
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Medicare Enrollment ID | O20210413000475 |
Identifier | Type | State | Issuer |
---|---|---|---|
1841881117 | NPI | - | NPPES |
93407718 | Medicaid | NM |
Taxonomy | Type | License (State) | Status |
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261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
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