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General NPI Number Information
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NPI Number | 1760379325
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Entity Type | Organization
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Legal Business Name | NEW MEXICO PREMIER HEALTH
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Dates
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Enumeration Date | 06/18/2025
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Last Update Date | 06/18/2025
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Provider Practice Location Address
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Address Line | 470 SANDSAGE RD NW
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City | LOS LUNAS
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State | NM
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Zip | 87031
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Country | US
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Telephone | 505-388-2223
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Fax |
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Provider Business Mailing Address
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Address Line | 235 MAIN ST SE
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City | LOS LUNAS
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State | NM
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Zip | 87031-7316
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Country | US
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Telephone | 505-388-2223
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Fax |
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Authorized Official
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Title or Position | OWNER/CMO
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Name | AMANDA CHRISTINE RENFRO
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Credential | APRN
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Telephone | 817-897-5310
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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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