MEDICARE: ERA HEALTHCARE 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	207Q00000X	Family Medicine Physician

General Provider Information

NPI Number	:	1942925383
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ERA HEALTHCARE LLC

Provider Business Mailing Address
First Line	:	3958 AGUA DE VIDA DR
Second Line	:
City	:	LAS CRUCES
State	:	NM
Zip	:	88012-7962
Country	:	US
Telephone Number	:	575-650-3324
Fax Number	:

Provider Business Practice Location Address
First Line	:	3958 AGUA DE VIDA DR
Second Line	:
City	:	LAS CRUCES
State	:	NM
Zip	:	88012-7962
Country	:	US
Telephone Number	:	575-650-3324
Fax Number	:

Authorized Official
Title or Position	:	NP
Name	:	REBECCA JOY ARCINIEGA
Credential	:	NP
Telephone Number	:	575-650-3324

Provider Enumeration Date	:	10/07/2022
Last Update Date	:	10/19/2022

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Directions to “ERA HEALTHCARE LLC ” Practice Location

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