Healthcare Provider Details

I. General information

NPI: 1992248736
Provider Name (Legal Business Name): RMCHCS URGENT CARE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/28/2016
Last Update Date: 09/15/2020
Certification Date: 09/15/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

520 NM HIGHWAY 564
GALLUP NM
87301-4873
US

IV. Provider business mailing address

1901 RED ROCK DR
GALLUP NM
87301-5683
US

V. Phone/Fax

Practice location:
  • Phone: 505-863-7000
  • Fax:
Mailing address:
  • Phone: 505-863-7347
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QU0200X
TaxonomyUrgent Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MR. DONALD SMITHBURG
Title or Position: CEO
Credential:
Phone: 505-863-7001