Organization Name: | ALAMOGORDO CLINIC LTD |
NPI Number: | 1093812521 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | DAVID BRENT ADAY (PRESIDENT) |
Mailing Address: | 1410 Aspen Drive Alamogordo |
State: | NM US |
Postal Code: | 88310 |
Phone Number: | 5054377000 |
Fax Number: | 5054346288 |
NPI Enumeration Date: | 09/19/2006 |
NPI Last Update Date: | 04/20/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 261QM1300X |
License Number: | 87-1 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NM |
Taxonomy Type: | Ambulatory Health Care Facilities |
Taxonomy Classification: | Clinic/Center |
Taxonomy Specialization: | Multi-Specialty |
Taxonomy Definition: |