| Primary Healthcare, Inc. | |
|
505 E 20th St Farmington NM 87401-2105 | |
| (505) 324-6300 | |
| Not Available |
| Full Name | Primary Healthcare, Inc. |
|---|---|
| Speciality | Family Medicine |
| Location | 505 E 20th St, Farmington, New Mexico |
| Authorized Official Name and Position | Dan A Dunn (OWNER) |
| Authorized Official Contact | 5053246300 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Primary Healthcare, Inc. 505 E 20th St Farmington NM 87401-2105 Ph: (505) 324-6300 | Primary Healthcare, Inc. 505 E 20th St Farmington NM 87401-2105 Ph: (505) 324-6300 |
| NPI Number | 1609051507 |
|---|---|
| Provider Enumeration Date | 01/09/2008 |
| Last Update Date | 06/14/2012 |
| Medicare PECOS PAC ID | 4880766864 |
|---|---|
| Medicare Enrollment ID | O20080708000592 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1609051507 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 90-188 (New Mexico) | Primary |
| Provider Name | Dan A Dunn |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1205839834 PECOS PAC ID: 0042382020 Enrollment ID: I20080709000087 |
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