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General NPI Number Information
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NPI Number | 1922426006
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Entity Type | Organization
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Legal Business Name | NEW MEXICO HEALTH CONNECTIONS
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Dates
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Enumeration Date | 04/04/2014
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Last Update Date | 04/04/2014
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Provider Practice Location Address
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Address Line | 2440 LOUISIANA BLVD NE
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City | ALBUQUERQUE
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State | NM
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Zip | 87110-4383
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Country | US
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Telephone | 505-633-8020
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Fax | 866-231-1344
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Provider Business Mailing Address
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Address Line | 2440 LOUISIANA BLVD NE
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City | ALBUQUERQUE
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State | NM
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Zip | 87110-4383
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Country | US
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Telephone | 505-633-8020
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Fax | 866-231-1344
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Authorized Official
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Title or Position | CHEIF EXECUTIVE OFFICER
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Name | MARTIN HICHEY
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Credential | M.D.
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Telephone | 505-633-8057
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 302R00000X
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Taxonomy Name | Health Maintenance Organization
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License Number |
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License Number State | NM
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