Provider Demographics
NPI:1639349426
Name:WORKMED INC.
Entity Type:Organization
Organization Name:WORKMED INC.
Other - Org Name:OPTIMUM MEDICAL CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:BENITO
Authorized Official - Middle Name:
Authorized Official - Last Name:GALLARDO
Authorized Official - Suffix:JR
Authorized Official - Credentials:MD
Authorized Official - Phone:575-521-1919
Mailing Address - Street 1:PO BOX 2278
Mailing Address - Street 2:
Mailing Address - City:LAS CRUCES
Mailing Address - State:NM
Mailing Address - Zip Code:88004-2278
Mailing Address - Country:US
Mailing Address - Phone:575-521-1919
Mailing Address - Fax:
Practice Address - Street 1:2404 S. LOCUST
Practice Address - Street 2:SUITE #2
Practice Address - City:LAS CRUCES
Practice Address - State:NM
Practice Address - Zip Code:88001-8627
Practice Address - Country:US
Practice Address - Phone:575-521-1919
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-07
Last Update Date:2011-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM89-197261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center