MEDICARE: BOSQUE WOMENS CARE PC

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	207VG0400X	Gynecology Physician	MD2006-0611	NM

General Provider Information

NPI Number	:	1427357920
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BOSQUE WOMENS CARE PC

Provider Business Mailing Address
First Line	:	6801 JEFFERSON ST NE STE 350
Second Line	:
City	:	ALBUQUERQUE
State	:	NM
Zip	:	87109-4361
Country	:	US
Telephone Number	:	505-847-4100
Fax Number	:

Provider Business Practice Location Address
First Line	:	6801 JEFFERSON ST NE STE 350
Second Line	:
City	:	ALBUQUERQUE
State	:	NM
Zip	:	87109-4361
Country	:	US
Telephone Number	:	505-926-1609
Fax Number	:	505-847-4945

Authorized Official
Title or Position	:	OWNER
Name	:	CARRIE D SWARTZ
Credential	:
Telephone Number	:	505-847-4100

Provider Enumeration Date	:	03/23/2011
Last Update Date	:	12/21/2023

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