MEDICARE: CARE FIRST LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician	2000-298	NM

General Provider Information

NPI Number	:	1912056904
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CARE FIRST LLC

Provider Business Mailing Address
First Line	:	3500 TRINITY DR STE B3
Second Line	:
City	:	LOS ALAMOS
State	:	NM
Zip	:	87544-2221
Country	:	US
Telephone Number	:	505-661-2411
Fax Number	:	505-662-7216

Provider Business Practice Location Address
First Line	:	3500TRINITY DR
Second Line	:	STE B3
City	:	LOS ALAMOS
State	:	NM
Zip	:	87544-2221
Country	:	US
Telephone Number	:	505-661-2411
Fax Number	:	505-662-7216

Authorized Official
Title or Position	:	SOLE MEMBER
Name	:	DR. HERBERT TYLER TAYLOR III
Credential	:	MD
Telephone Number	:	505-661-2411

Provider Enumeration Date	:	01/09/2007
Last Update Date	:	12/01/2011

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Directions to “CARE FIRST LLC ” Practice Location

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