Main Street Medical Center, Llc
LBN: Main Street Medical Center, Llc
Main Street Medical Center, Llc is an health care organization with primary practice located at 200 Pioneer Rd Ste A, Red River NM 87558-0010. The organization recently has 2 registered licenses in different health care specialties including Ambulatory Health Care Facilities / Primary Care, Physician Assistants & Advanced Practice Nursing Providers / Family. Physician Assistants & Advanced Practice Nursing Providers / Family is the primary health care specialty.
Main Street Medical Center, Llc can be contacted via phone (575) 754-6330, or through Cross, Jessica L via phone (575) 754-6330.
Contact Information
Primary practice address
200 Pioneer Rd Ste A
Red River NM 87558-0010
Phone: (575) 754-6330
Fax: (575) 754-6232
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Ambulatory Health Care Facilities / Primary Care | 261QP2300X | ||
| Physician Assistants & Advanced Practice Nursing Providers / Family | 363LF0000X | CNP-01822 | New Mexico |
Profile Details
| NPI number | 1225389919 |
|---|---|
| LBN Legal business name | Main Street Medical Center, Llc |
| DBA Doing business as | |
| Authorized official | Cross, Jessica L FNP-BC |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | Sep 21st, 2012 |
| Last updated | Mar 4th, 2024 - about 6 months 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 | 1225389919 | NPPES |
| New Mexico | Other | 1225389919 | ORG 2 NPI |
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