PHC-LAS CRUCES INC NPI 1164445136

NPI Information

NPI: 1164445136
Provider Name: PHC-LAS CRUCES INC
Classification: Family Medicine - 207Q00000X
Entity Type: Organization

CLIA Number: 32D0537076

Address:
2450 S TELSHOR BLVD
LAS CRUCES, NM
ZIP 88011
Phone: (575) 522-8641
Get Directions

PHC-LAS CRUCES INC is a family medicine in Las Cruces, NM. The provider is family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. PHC-LAS CRUCES INC NPI is 1164445136. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

2450 S TELSHOR BLVD
LAS CRUCES, NM
ZIP 88011-069
Phone: (575) 522-8641
Fax: (575) 521-5013

The provider's authorized official is Donald J. Bivacca .
The authorized official title is President and has the following contact phone number (615) 920-7000.

The CLIA number assigned to this NPI record is 32D0537076 - hospital with a certificate type of Certificate of Accreditation.

The enumeration date for this NPI number is 7/25/2006 and was last updated on 3/17/2016.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	Primary
1	207L00000X	Anesthesiology		No
2	207P00000X	Emergency Medicine		No
3	207R00000X	Internal Medicine		No
4	207X00000X	Orthopaedic Surgery		No
5	2085R0202X	Radiology	Diagnostic Radiology	No
6	208600000X	Surgery		No
7	363L00000X	Nurse Practitioner		No
8	367500000X	Nurse Anesthetist, Certified Registered		No
9	207Q00000X	Family Medicine		Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	26001373	MEDICAID	NEW MEXICO
2	200521039	MEDICARE PIN	NEW MEXICO

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

NPI Synchronization or Removal

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