MEDICARE: HEALTHCARE RESOURCES, LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207R00000X	Internal Medicine Physician

General Provider Information

NPI Number	:	1356396451
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HEALTHCARE RESOURCES, LLC

Provider Business Mailing Address
First Line	:	PO BOX 51375
Second Line	:
City	:	ALBUQUERQUE
State	:	NM
Zip	:	87181-1375
Country	:	US
Telephone Number	:	505-243-7717
Fax Number	:	505-243-7722

Provider Business Practice Location Address
First Line	:	717 ENCINO PL NE
Second Line	:	SUITE 17
City	:	ALBUQUERQUE
State	:	NM
Zip	:	87102-2611
Country	:	US
Telephone Number	:	505-243-7717
Fax Number	:	505-243-7722

Authorized Official
Title or Position	:	MANAGER
Name	:	PETER D RONKOS
Credential	:	MBA
Telephone Number	:	505-243-7717

Provider Enumeration Date	:	05/24/2006
Last Update Date	:	10/02/2007

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Directions to “HEALTHCARE RESOURCES, LLC ” Practice Location

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