BLUE AND RED BIRD CORPORATION PC. NPI 1124579958

NPI Information

BLUE AND RED BIRD CORPORATION, PC. is a primary care clinic center in Clovis, NM. BLUE AND RED BIRD CORPORATION, PC. NPI is 1124579958. The provider is registered as an organization entity type.

The provider's business location address is:

815 W 14TH ST
CLOVIS, NM
ZIP 88101-514
Phone: (575) 762-6492
Fax: (757) 935-8333

The provider's authorized official is Ali M Ghaffari .
The authorized official title is President and has the following contact phone number (575) 762-6492.

The CLIA number assigned to this NPI record is 32D0690009 - physician office with a certificate type of Certificate for Provider-Performed Microscopy Procedures (PPMP).

The enumeration date for this NPI number is 10/17/2016 and was last updated on 10/17/2016.

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:

Other Identifiers

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

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