# RIBERA MEDICAL, LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1194268599
- **Authorized official:** MRS. OLGA Z. LUCERO RN (MANAGER-OWNER)
- **Authorized official phone:** (505) 226-8920

## Contact information

- **Practice address:** 6341 RIVERSIDE PLAZA LN NW, SUITE A, ALBUQUERQUE, NM 87120-2646
- **Practice address phone:** (505) 226-8920
- **Practice address fax:** (866) 406-4513
- **Mailing address:** 6341 RIVERSIDE PLAZA LN NW, SUITE A, ALBUQUERQUE, NM 87120-2646
- **Mailing address phone:** (505) 226-8920
- **Mailing address fax:** (866) 406-4513

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261Q00000X | Clinic/Center | RN-79594 | NM | — |
| 261QM2500X | Medical Specialty Clinic/Center | MD-88-97 | NM | Yes |

## Other

- **Enumeration date:** 12/02/2016
- **Last updated:** 12/02/2016