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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