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General NPI Number Information
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NPI Number | 1144966136
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Entity Type | Organization
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Legal Business Name | G & M MEDICAL CENTER
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Dates
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Enumeration Date | 05/11/2022
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Last Update Date | 11/01/2022
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Provider Practice Location Address
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Address Line | 1316 JACKIE RD SE STE 400
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City | RIO RANCHO
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State | NM
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Zip | 87124-1045
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Country | US
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Telephone | 505-415-0719
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Fax | 505-372-0093
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Provider Business Mailing Address
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Address Line | 1316 JACKIE RD SE STE 500
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City | RIO RANCHO
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State | NM
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Zip | 87124-6607
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Country | US
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Telephone | 505-415-0719
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Fax | 505-372-0093
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Authorized Official
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Title or Position | OWNER/PROVIDER
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Name | RONALD M EDWARDS
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Credential | FNP-BC AGACNP
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Telephone | 505-415-0719
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QU0200X
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Taxonomy Name | Urgent Care Clinic/Center
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License Number |
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License Number State |
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