| Sacramento Mountain Medical Center | |
|
74 James Canyon Hwy Cloudcroft NM 88317 | |
| (505) 682-2542 | |
| (505) 682-3075 |
| Full Name | Sacramento Mountain Medical Center |
|---|---|
| Speciality | Clinic/Center |
| Location | 74 James Canyon Hwy, Cloudcroft, 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 |
|---|---|
| Sacramento Mountain Medical Center Po Box 2267 Santa Fe NM 87504-2267 Ph: () - | Sacramento Mountain Medical Center 74 James Canyon Hwy Cloudcroft NM 88317 Ph: (505) 682-2542 |
| NPI Number | 1326115338 |
|---|---|
| Provider Enumeration Date | 11/29/2006 |
| Last Update Date | 01/09/2021 |
| Medicare PECOS PAC ID | 2062324684 |
|---|---|
| Medicare Enrollment ID | O20110321000720 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1326115338 | NPI | - | NPPES |
| S7573 | Medicaid | NM | |
| 3209776 | Other | OTHER ID NUMBER |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | 3033 (New Mexico) | Primary |
| 332900000X | Non-pharmacy Dispensing Site | CL00007514 (New Mexico) | Secondary |
Bloom Medical Services Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 1315 Burro Ave, Cloudcroft, NM 88317 Phone: 575-682-2002 |