MEDICARE: MERIT FAMILY MEDICINE

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	261QP2300X	Primary Care Clinic/Center

General Provider Information

NPI Number	:	1881251411
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MERIT FAMILY MEDICINE

Provider Business Mailing Address
First Line	:	PO BOX 44308
Second Line	:
City	:	RIO RANCHO
State	:	NM
Zip	:	87174-4308
Country	:	US
Telephone Number	:	505-315-3541
Fax Number	:	505-445-4904

Provider Business Practice Location Address
First Line	:	4801 MCMAHON BLVD NW STE 245
Second Line	:
City	:	ALBUQUERQUE
State	:	NM
Zip	:	87114-5478
Country	:	US
Telephone Number	:	505-315-3541
Fax Number	:	505-445-4904

Authorized Official
Title or Position	:	BILLER/CREDENTIALER
Name	:	JOSE SAAVEDRA
Credential	:
Telephone Number	:	505-315-3541

Provider Enumeration Date	:	05/20/2019
Last Update Date	:	07/01/2024

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