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General NPI Number Information
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NPI Number | 1467303685
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Entity Type | Organization
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Legal Business Name | PICURIS MEDICAL CENTER
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Dates
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Enumeration Date | 02/04/2026
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Last Update Date | 02/04/2026
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Provider Practice Location Address
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Address Line | 201 K 2 BUFFALO TRAIL
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City | PENASCO
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State | NM
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Zip | 87553
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Country | US
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Telephone | 575-281-8010
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Fax | 833-438-5215
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Provider Business Mailing Address
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Address Line | 201 K 2 BUFFALO TRAIL
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City | PENASCO
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State | NM
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Zip | 87553
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Country | US
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Telephone | 575-281-8010
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Fax | 833-438-5215
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Authorized Official
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Title or Position | CLINICAL PRACTICED MANAGER
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Name | JESSICA TAYLOR CHACON
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Credential |
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Telephone | 505-927-0918
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number |
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License Number State |
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