Provider Demographics
NPI:1326371279
Name:MOTHER OF MERCY ACUPUNCTURE&HERBAL CLINIC
Entity Type:Organization
Organization Name:MOTHER OF MERCY ACUPUNCTURE&HERBAL CLINIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT- OF NON-PROFIT
Authorized Official - Prefix:DR
Authorized Official - First Name:MARGARET
Authorized Official - Middle Name:DIANE
Authorized Official - Last Name:HURSH
Authorized Official - Suffix:
Authorized Official - Credentials:DOM
Authorized Official - Phone:1505-244-8401
Mailing Address - Street 1:6017 HANNETTE NE
Mailing Address - Street 2:DIANE M. HURSH DOM
Mailing Address - City:ALBUQUERQUE , 87110
Mailing Address - State:NM
Mailing Address - Zip Code:87110-5914
Mailing Address - Country:US
Mailing Address - Phone:150-524-4841
Mailing Address - Fax:150-524-3155
Practice Address - Street 1:301 WASHINGTON SE
Practice Address - Street 2:MOTHER OF MERCY ACUPUNCTURE & HERB CLINIC
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87108-2734
Practice Address - Country:US
Practice Address - Phone:150-524-4840
Practice Address - Fax:150-524-3147
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-09-10
Last Update Date:2009-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM57-1172394261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center