# MEDCOM MEDICAL, LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Palo Verde Family Care, Inc.
- **Organization subpart:** No

## Provider details

- **NPI number:** 1205962792
- **Authorized official:** OSCAR ERNESTO ANDRADE MD (PRESIDENT)
- **Authorized official phone:** (928) 402-0952

## Contact information

- **Practice address:** 108 SOUTH BROAD ST., GLOBE, AZ 85501
- **Practice address phone:** (928) 425-6592
- **Practice address fax:** (928) 425-7566
- **Mailing address:** PO BOX 1508, CLAYPOOL, AZ 85539
- **Mailing address phone:** (928) 402-0952
- **Mailing address fax:** (928) 402-4774

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | 27758 | AZ | Yes |

## Other

- **Enumeration date:** 02/26/2007
- **Last updated:** 10/19/2015

## 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 |