| NPI | 1831266311 |
|---|---|
| Doing Business As | WESTERN NM MEDICAL GROUP THOREAU |
| Entity Type | Organization |
| Authorized Contact | ROBERTA LEE CFO 505-982-5565 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
| Additional Taxonomies | 332900000X Non-Pharmacy Dispensing Site (Licence: NM CL00007400) |
| Enumeration Date | 2006-11-29 |
| Last Update Date | 2022-07-21 |