# PLACITAS MOUNTAIN MEDICAL, INC

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** PLACITAS MOUNTAIN MEDICAL, INC.
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1902333776
- **Legal business name:** PLACITAS MOUNTAIN MEDICAL, INC.
- **Authorized official:** JAMES MARC BEVERLY (OWNER)
- **Authorized official phone:** (505) 281-5180

## Contact information

- **Practice address:** 104 QUAIL TRL UNIT B, EDGEWOOD, NM 87015-7185
- **Practice address phone:** (505) 309-0455
- **Mailing address:** 12127B HWY 14 N STE 5, CEDAR CREST, NM 87008-9499
- **Mailing address phone:** (505) 281-5180

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QU0200X | Urgent Care Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 05/11/2017
- **Last updated:** 05/11/2017