Healthcare Provider Details

I. General information

NPI: 1043561699
Provider Name (Legal Business Name): SMART CARE, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/23/2012
Last Update Date: 09/23/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2801 MISSOURI AVE STE 12
LAS CRUCES NM
88011-5061
US

IV. Provider business mailing address

1309 WALDEN DR
LAS CRUCES NM
88001-4329
US

V. Phone/Fax

Practice location:
  • Phone: 575-522-6900
  • Fax: 575-522-8891
Mailing address:
  • Phone: 575-649-9433
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP2300X
TaxonomyPrimary Care Clinic/Center
License NumberCNP01746
License Number StateNM

VIII. Authorized Official

Name: KATHERINE EMERICK
Title or Position: PRESIDENT / OWNER
Credential: CNP
Phone: 575-649-9433