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Organization
MEDCOM MEDICAL, LLC
Active
Organization
MEDCOM MEDICAL, LLC
Active
Other names
Palo Verde Family Care, Inc.
Organization subpart
No
Provider details
NPI number
Authorized official
OSCAR ERNESTO ANDRADE MD (PRESIDENT)
(928) 402-0952
Entity
Organization
Contact information
Practice address
108 SOUTH BROAD ST., GLOBE, AZ 85501
(928) 425-6592
(928) 425-7566
Mailing address
PO BOX 1508, CLAYPOOL, AZ 85539
(928) 402-0952
(928) 402-4774
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
27758
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1225107667
SHERIDA CARLSON PA NPI
AZ
01
—
1275685521
AZ NPI OSCAR ERNEST ANDRA
AZ
01
—
1871545905
JEAN TURNEY-SHAW FPN NPI
AZ
05
—
475592
—
AZ
Enumeration date
02/26/2007
Last updated
10/19/2015
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