| Angel Fire Primary Care | |
|
200 A Pioneer Road Red River NM 87558-0000 | |
| (575) 754-1773 | |
| (505) 989-3536 |
| Full Name | Angel Fire Primary Care |
|---|---|
| Speciality | General Practice |
| Location | 200 A Pioneer Road, Red River, New Mexico |
| Authorized Official Name and Position | Lesa D Fraker (PRESIDENT) |
| Authorized Official Contact | 5059898707 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Angel Fire Primary Care 707 Paseo De Peralta Santa Fe NM 87501-1922 Ph: (505) 989-8707 | Angel Fire Primary Care 200 A Pioneer Road Red River NM 87558-0000 Ph: (575) 754-1773 |
| NPI Number | 1053672485 |
|---|---|
| Provider Enumeration Date | 06/01/2012 |
| Last Update Date | 06/01/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1053672485 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208D00000X | General Practice | (* (Not Available)) | Primary |
Main Street Medical Center, Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 105 E Main Street, Red River, NM 87558 Phone: 575-754-6330 Fax: 575-754-6232 |