SOUTHWEST CARE CENTER JEFFERSON ALBUQUERQUE NPI 1750767810

NPI Information

NPI: 1750767810
Provider Name: SOUTHWEST CARE CENTER JEFFERSON ALBUQUERQUE
Classification: Clinic/Center - 261QF0400X
Entity Type: Organization

Specialization: Federally Qualified Health Center (FQHC)

Address:
4710 JEFFERSON NE
SUITE A
ALBUQUERQUE, NM
ZIP 87109
Phone: (505) 955-9454
Get Directions

SOUTHWEST CARE CENTER JEFFERSON ALBUQUERQUE is a federally qualified health center (fqhc) clinic center in Albuquerque, NM. SOUTHWEST CARE CENTER JEFFERSON ALBUQUERQUE NPI is 1750767810. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

4710 JEFFERSON NE
SUITE A
ALBUQUERQUE, NM
ZIP 87109
Phone: (505) 955-9454
Fax: (505) 888-9644

The provider's authorized official is Michael Adams .
The authorized official title is Ceo and has the following contact phone number (505) 989-8200.

The enumeration date for this NPI number is 7/30/2015 and was last updated on 2/7/2023.

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	174400000X	Specialist		No
2	261QM1300X	Clinic/Center	Multi-Specialty	No
3	261QF0400X	Clinic/Center	Federally Qualified Health Center (FQHC)	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	55202080	MEDICAID	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: 4/28/2024

NPI Synchronization or Removal

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