RIO GRANDE GERIATRICS AND FAMILY PRACTICE LLC


Address: 8328 Cascade Park Ave Nw, Albuquerque, NM 87120-6523
Phone: 5052203873

RIO GRANDE GERIATRICS AND FAMILY PRACTICE LLC (NPI# 1639505712) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1639505712
Entity Type Organization
Organization Name RIO GRANDE GERIATRICS AND FAMILY PRACTICE LLC
Practice Address 8328 Cascade Park Ave Nw
Albuquerque
NM 87120-6523
Practice Telephone 5052203873
Practice Fax Number 5057925222
Mailing Telephone 5052203873
Mailing Fax Number 5057925222
Enumeration Date 2013-09-19
Last Update Date 2013-09-19
Authorized Official Name MIKE A WALLACE (CEO MEDICAL DIRECTOR)
Authorized Official Telephone 5052203873
Authorized Official Credential CNP
Is Organization Subpart N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 163WG0600X Registered Nurse
Specialization: Gerontology
Nursing Service Providers

Office Location

Street Address 8328 CASCADE PARK AVE NW
City ALBUQUERQUE
State NM
Zip Code 87120-6523

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Taxonomy Information

Taxonomy Code 163WG0600X
Grouping Nursing Service Providers
Classification Registered Nurse
Specialization Gerontology

Taxonomy Definition

Definition to come...

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1770814915 Roger Louis Gavi Registered Nurse 3604 Cameo Dr Se, Albuquerque, NM 87105-0204 2010-01-28
1255480828 Sara Louise Santilli Registered Nurse 4253 Montgomery Blvd Ne, Suite 100, Albuquerque, NM 87109-1106 2007-01-10

Competitor

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City ALBUQUERQUE
Zip Code 87120

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Dataset Information

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.

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