Provider Demographics
NPI:1467761338
Name:LAS CRUCES QUICKCARE, LLC
Entity Type:Organization
Organization Name:LAS CRUCES QUICKCARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:LINDA
Authorized Official - Middle Name:
Authorized Official - Last Name:CHAVES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:505-550-1553
Mailing Address - Street 1:PO BOX 12849
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87195-0849
Mailing Address - Country:US
Mailing Address - Phone:505-550-1553
Mailing Address - Fax:888-782-9109
Practice Address - Street 1:530 N TELSHOR BLVD
Practice Address - Street 2:STE. C
Practice Address - City:LAS CRUCES
Practice Address - State:NM
Practice Address - Zip Code:88011-8243
Practice Address - Country:US
Practice Address - Phone:575-532-2004
Practice Address - Fax:575-532-2441
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-09-27
Last Update Date:2012-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty