Healthcare Provider Details

I. General information

NPI: 1760740245
Provider Name (Legal Business Name): MEMORIAL PROMPT CARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/02/2012
Last Update Date: 10/30/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3030 W PICACHO AVE SUITE D
LAS CRUCES NM
88007-4721
US

IV. Provider business mailing address

3030 W PICACHO AVE SUITE D
LAS CRUCES NM
88007-4721
US

V. Phone/Fax

Practice location:
  • Phone: 575-521-5277
  • Fax:
Mailing address:
  • Phone: 575-541-7420
  • 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: JAMES MCGONNELL
Title or Position: VFO
Credential:
Phone: 575-521-2291