Home » New Mexico » 87558 » Main Street Medical Center, Llc

Main Street Medical Center, Llc

Main Street Medical Center, Llc is a health care provider in Red River, NM. In this page you will find its mailing address, practice location, phone number, specialty etc.

physician-icon Basic Information

Practice Location 305 Pioneer Rd, Ste A, Red River, NM 87558-0010, US
Practice Location Phone575-754-6330
Practice Location Fax575-754-6232
Legal Business NameMAIN STREET MEDICAL CENTER, LLC
NPI ?1225389919
Entity TypeOrganization
Enumeration Date ? Sep 21, 2012
Last Update Date ? Feb 5, 2018
Note:
NPI: National Provider Identifier issued to health care providers by Centers for Medicare and Medicaid Services (CMS).

specialty-icon Specialties & Licenses of Main Street Medical Center, Llc

SpecialtySpecializationLicenseLicense State
Clinic/CenterPrimary Care
Nurse PractitionerFamily CNP-01822New Mexico

legacy-id-icon Legacy Provider IDs of Main Street Medical Center, Llc

Provider IdIssuer StateIssuer TypeIssuer
1225389919New MexicoOtherORG 2 NPI

official-icon Authorized Official of Main Street Medical Center, Llc

An authorized official is an appointed official with the legal authority to make changes and/or updates to the Main Street Medical Center, Llc's status and to commit the provider to fully abide by the laws and regulations relating to the National Provider Identifier (NPI).

Authorized Official Jessica L Cross (FNP-BC)
Authorized Official Title/PositionOWNER
Authorized Official Phone Number575-754-6330