Organization
AMERIGROUP COMMUNITY CARE OF NEW MEXICO, INC.
Active
Other names
AMERIGROUP New Mexico, Inc.
Organization subpart
No
Provider details
NPI number
Authorized official
MARC RUSSO (PRESIDENT)
(212) 518-5250
Entity
Organization
Contact information
Practice address
2 PARK SQ, 6565 AMERICAS PARKWAY, NE, SUITE 200, ALBUQUERQUE, NM 87110-5374
(505) 563-5554
Mailing address
2 PARK SQ, 6565 AMERICAS PARKWAY, NE, SUITE 200, ALBUQUERQUE, NM 87110-5374
(505) 563-5554
Taxonomy
Speciality
Code
Description
License number
State
302R00000X
Health Maintenance Organization
Primary
5019
NM
Other
Enumeration date
10/31/2007
Last updated
01/07/2014
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