Organization
COMPCARE NEW MEXICO INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LISA GURULE (CREDENTIALING SPECIALIST)
(505) 367-3547
Entity
Organization
Contact information
Practice address
706 LA JOYA ST STE C, ESPANOLA, NM 87532-2877
(505) 367-3547
Mailing address
706 LA JOYA ST STE C, ESPANOLA, NM 87532-2877
(505) 367-3547
Taxonomy
Speciality
Code
Description
License number
State
261QU0200X
Urgent Care Clinic/Center
Primary
R25973
NM
Other
Enumeration date
10/15/2009
Last updated
10/23/2009
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