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NPI Code Detail

MEDICARE: BEN ARCHER HEALTH CENTER

MEDICARE: BEN ARCHER HEALTH CENTER
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
1261Q00000XClinic/Center6561NM
2261QF0400XFederally Qualified Health Center (FQHC)321856NM

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 : 1780619411
Entity Type Code : Organization
Provider Name (Legal Business Name) : BEN ARCHER HEALTH CENTER
Provider Business Mailing Address
First Line : PO BOX 370
Second Line :
City : HATCH
State : NM
Zip : 87937-0370
Country : US
Telephone Number : 575-267-3280
Fax Number : 575-267-1747
Provider Business Practice Location Address
First Line : 1600 THORPE RD
Second Line :
City : LAS CRUCES
State : NM
Zip : 88012-9776
Country : US
Telephone Number : 575-382-9292
Fax Number : 575-382-2061
Authorized Official
Title or Position : EXECUTIVE DIRECTOR
Name : MARY ALICE GARAY
Credential :
Telephone Number : 575-267-3280
Provider Enumeration Date : 07/11/2006
Last Update Date : 09/29/2010

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Directions to “BEN ARCHER HEALTH CENTER ” Practice Location

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