Oak Street Clinic
LBN: Bernalillo Family Health Clinic, Llc
Oak Street Clinic is an health care organization with primary practice located at 200 Oak St Ne Suite 2, Albuquerque NM 87106-4740. The organization recently has 3 registered licenses in different health care specialties including Ambulatory Health Care Facilities / Primary Care, Ambulatory Health Care Facilities / Urgent Care, Laboratories / Clinical Medical Laboratory. Ambulatory Health Care Facilities / Primary Care is the primary health care specialty.
Bernalillo Family Health Clinic, Llc can be contacted via phone (505) 508-0197, or through Deluisa, Jason via phone (505) 331-0295.
Contact Information
Primary practice address
200 Oak St Ne Suite 2
Albuquerque NM 87106-4740
Phone: (505) 508-0197
Fax: (505) 508-0465
Website:
Authorized official contact:
Name: Deluisa, Jason Certified Nurse Practitioner (CNP)
Phone: (505) 331-0295
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Ambulatory Health Care Facilities / Primary Care | 261QP2300X | CNP-01518 | New Mexico |
| Ambulatory Health Care Facilities / Urgent Care | 261QU0200X | ||
| Laboratories / Clinical Medical Laboratory | 291U00000X |
Profile Details
| NPI number | 1801100466 |
|---|---|
| LBN Legal business name | Bernalillo Family Health Clinic, Llc |
| DBA Doing business as | Oak Street Clinic |
| Authorized official | Deluisa, Jason Certified Nurse Practitioner (CNP) |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | Aug 5th, 2010 |
| Last updated | Feb 6th, 2015 - about 9 years ago |
1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1801100466 | NPPES |
| New Mexico | MEDICAID | Q7732 | |
| New Mexico | MEDICAID | 21253790 | |
| New Mexico | MEDICAID | 77304853 | |
| New Mexico | MEDICAID | 10326855 | |
| New Mexico | MEDICAID | 37805771 |
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