FNCH OUTPATIENT SERVICES (NPI# 1417472192) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1417472192 |
| Entity Type | Organization |
| Organization Name | FNCH OUTPATIENT SERVICES |
| Other Organization Name | FNCH OUTPATIENT SERVICES |
| Practice Address |
634 Manzano Street Ne Albuquerque NM 87110 |
| Mailing Address |
5608 Zuni Rd Se Albuquerque NM 87108-2926 |
| Practice Telephone | 5052622481 |
| Practice Fax Number | 5052657045 |
| Mailing Telephone | 5052622481 |
| Mailing Fax Number | 5052657045 |
| Enumeration Date | 2017-08-03 |
| Last Update Date | 2018-06-16 |
| Authorized Official Name | SUZETTE GUTIERREZ (CREDENTIALING SPECIALIST) |
| Authorized Official Telephone | 5052626567 |
| Is Organization Subpart | Y |
| Parent Organization Name | FIRST NATIONS COMMUNITY HEALTH SOURCE, INC. |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QF0400X |
Clinic/Center Specialization: Federally Qualified Health Center (FQHC) |
Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NM | 0004-6912 | 05 |
| Other Name | Type Code |
|---|---|
| FNCH Outpatient Services | Doing Business As Name - Organization |
| FNCH Outpatient Services | Other Name - Individual/Organization |
| Street Address |
634 MANZANO STREET NE |
| City | ALBUQUERQUE |
| State | NM |
| Zip Code | 87110 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215550199 | Sabrina Jennifer Lujan | Counselor | 8401 Constitution Ave Nw, Albuquerque, NM 87110 | 2020-05-26 |
| 1649829318 | Robert D. Oliver | Technician | 2705 Texas Street Ne, Albuquerque, NM 87110 | 2019-09-05 |
| 1033770904 | Life Re-created LLC | Counselor | 3939 San Pedro Dr. Ne, Bld C, Ste 8, Albuquerque, NM 87110 | 2019-06-21 |
| 1497319693 | Clear Choice Vision Care, LLC | Optometrist | 6600 Menaul Blve Ne, Suite M5a, Albuquerque, NM 87110 | 2019-04-24 |
| 1790257558 | Diana M Nicolas | Dietitian, Registered | 8300 Constitution Ave Ne Bld D, Albuquerque, NM 87110 | 2018-12-18 |
| 1689168403 | Robin N Hermes, Md, PC | Anesthesiology | 2440 Lousiana Blvd. Ne, Ste 580, Albuquerque, NM 87110 | 2018-06-15 |
| 1710481726 | Desert Mountain Eyecare LLC | Optometrist | 5504 Menaul Blvd Ne Ste Aandb, Albuquerque, NM 87110 | 2018-03-23 |
| 1659873131 | Amanda Lacasse | Registered Nurse | 6400 Uptown Blvd Ne Suite 360 West, Albuquerque, NM 87110 | 2018-03-01 |
| 1518485655 | Danielle Liegh Wyne | Counselor | 6121 Indian School Rd, Suite 141, Albuquerque, NM 87110 | 2017-09-08 |
| 1265957237 | Myrrhine Faller | Speech-Language Pathologist | 6020 Constitution Ave. Ne, Suite 4, Albuquerque, NM 87110 | 2017-08-10 |
| Find all providers in zip 87110 | ||||
| Taxonomy Code | 261QF0400X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Federally Qualified Health Center (FQHC) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235698937 | First Nations Community Health Source, Inc. | Clinic/Center | 7317 Central Ave Ne, Albuquerque, NM 87108-2015 | 2019-03-13 |
| 1770009524 | Fnch Sbhc Emerson | Clinic/Center | 620 Georgia St Se, Albuquerque, NM 87108-3806 | 2017-08-14 |
| 1326570425 | Fnch Sbhc Wilson Location | Clinic/Center | 1138 Cardenas Dr Se, Albuquerque, NM 87108-4809 | 2017-03-29 |
| 1396277497 | Fnch Sbhc Grant Location | Clinic/Center | 1111 Easterday Dr Ne, Albuquerque, NM 87112-5115 | 2017-03-29 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487265666 | Hidalgo Medical Services | Clinic/Center | 105 1/2 N East St., Santa Clara, NM 88026 | 2020-08-12 |
| 1902436702 | La Clinica De Familia, Incorporated | Clinic/Center | 510 E Lisa Dr Bldg 2, Chaparral, NM 88081-7809 | 2020-01-21 |
| 1114578671 | La Clinica De Familia, Inc. | Clinic/Center | 100 Shrode Rd, Anthony, NM 88021-7350 | 2019-09-26 |
| 1083262422 | Presbyterian Medical Services | Clinic/Center | 28 Panther Parkway, 63 North Highway, Pecos, NM 87552 | 2019-08-29 |
| 1669930392 | El Centro Family Health | Clinic/Center | 1401 8th Street, Springer, NM 87747 | 2019-03-12 |
| 1487119608 | Presbyterian Medical Services | Clinic/Center | 1 Salomon Griego Road, Veguita, NM 87062 | 2019-02-01 |
| 1417440777 | Las Clinicas Del Norte Incorporated | Clinic/Center | 1797b St. Rd 502, Santa Fe, NM 87506 | 2018-06-12 |
| 1467971986 | Hidalgo Medical Services | Clinic/Center | 3200 32nd St Bypass, Silver City, NM 88061 | 2017-09-15 |
| 1689034662 | La Clinica De Familia, Inc. | Clinic/Center | 6301 Nm Highway 28, Anthony, NM 88021 | 2016-03-03 |
| 1487026563 | Ben Archer Health Center | Clinic/Center | 3331 Del Rey Blvd., Las Cruces, NM 88012 | 2015-10-28 |
| Find all providers with the same taxonomy | ||||
| City | ALBUQUERQUE |
| Zip Code | 87110 |
Please comment or provide details below to improve the information on FNCH OUTPATIENT SERVICES.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.