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NPI Code Detail

MEDICARE: PEAK MEDICAL NEW MEXICO NO. 3 LLC

MEDICARE: PEAK MEDICAL NEW MEXICO NO. 3 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
1314000000XSkilled Nursing Facility1037NM

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1932153855
Entity Type Code : Organization
Provider Name (Legal Business Name) : PEAK MEDICAL NEW MEXICO NO. 3 LLC
Provider Business Mailing Address
First Line : 5901 OURAY RD NW
Second Line :
City : ALBUQUERQUE
State : NM
Zip : 87120-1381
Country : US
Telephone Number : 505-836-0023
Fax Number :
Provider Business Practice Location Address
First Line : 5901 OURAY RD NW
Second Line :
City : ALBUQUERQUE
State : NM
Zip : 87120-1381
Country : US
Telephone Number : 505-836-0023
Fax Number : 505-836-5169
Authorized Official
Title or Position : ASSISTANT SECRETARY
Name : MICHAEL BERG
Credential :
Telephone Number : 505-468-4752
Provider Enumeration Date : 05/22/2006
Last Update Date : 02/08/2017

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Directions to “PEAK MEDICAL NEW MEXICO NO. 3 LLC ” Practice Location

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