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NPI Code Detail

MEDICARE: PHC LAS CRUCES

MEDICARE: PHC LAS CRUCES
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
1282N00000XGeneral Acute Care Hospital282N00000XNM

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1376891010
Entity Type Code : Organization
Provider Name (Legal Business Name) : PHC LAS CRUCES
Provider Business Mailing Address
First Line : 2450 S TELSHOR BLVD
Second Line :
City : LAS CRUCES
State : NM
Zip : 88011-5076
Country : US
Telephone Number : 575-532-4480
Fax Number : 575-532-4463
Provider Business Practice Location Address
First Line : 2450 S TELSHOR BLVD
Second Line :
City : LAS CRUCES
State : NM
Zip : 88011-5076
Country : US
Telephone Number : 575-532-4480
Fax Number : 575-532-4463
Authorized Official
Title or Position : COLLECTION/SUPERVISOR
Name : MR. PAUL TWIST
Credential :
Telephone Number : 575-522-8641
Provider Enumeration Date : 08/28/2012
Last Update Date : 08/28/2012

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Practice Fax:
1063951689 — COLIN BYRD D.O.
Practice Location Address:
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LAS CRUCES, NM
88011-5076
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1720505571 — SOUTHWEST EMERGENCY MEDICAL ASSOCIATES OF NM PC
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LAS CRUCES, NM
88011-5076
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1740767482 — DR. IKE IKPONMWOSA IYAMU DNP, CRNA
Practice Location Address:
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Practice Fax: 575-532-4431

Directions to “PHC LAS CRUCES ” Practice Location

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