EL CENTRO FAMILY HEALTH; NPI #1275798969

Contact Information

EL CENTRO FAMILY HEALTH

555 WAGON MOUND HIGHWAY
ROY, NM 87743-0148

Phone: 575-485-2484
Fax: 575-485-2261
Website:

	Specialty	Taxonomy Code	Specialty Code	Provider Type
	Federally Qualified Health Center (FQHC)	261QF0400X	B4[14]	Federally Qualified Health Center

Indicates primary specialty

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NPI Profile & details for EL CENTRO FAMILY HEALTH

NPI # 1275798969

LBN Legal business name EL CENTRO FAMILY HEALTH

Authorized official LORE PEASE - (CEO)

Entity Organization

Organization subpart ¹ No

Enumeration date 07/23/2008

Last updated 11/21/2014 - About 12 years ago

Identifiers

NM	License #	6103
NM	Medicaid	45542
NM	Other	1780689034	ORGANIZATION NPPES

¹ Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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