Provider Demographics
NPI:1649330325
Name:BESTCARE FAMILY MEDICAL SERVICES
Entity type:Organization
Organization Name:BESTCARE FAMILY MEDICAL SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:JEFFREY
Authorized Official - Last Name:O'CONNELL
Authorized Official - Suffix:
Authorized Official - Credentials:FNP-C
Authorized Official - Phone:505-527-2300
Mailing Address - Street 1:2701 W PICACHO AVE
Mailing Address - Street 2:SUITE 8
Mailing Address - City:LAS CRUCES
Mailing Address - State:NM
Mailing Address - Zip Code:88007-4775
Mailing Address - Country:US
Mailing Address - Phone:505-527-2300
Mailing Address - Fax:505-527-2302
Practice Address - Street 1:2701 W PICACHO AVE
Practice Address - Street 2:SUITE 8
Practice Address - City:LAS CRUCES
Practice Address - State:NM
Practice Address - Zip Code:88007-4775
Practice Address - Country:US
Practice Address - Phone:505-527-2300
Practice Address - Fax:505-527-2302
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-11
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMR37541363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty