PECOS VALLEY WELLNESS LLC NPI 1407382567

NPI Information

NPI: 1407382567
Provider Name: PECOS VALLEY WELLNESS LLC
Classification: Clinic/Center - 261QP2300X
Entity Type: Organization

Specialization: Primary Care

CLIA Number: 32D2116788

Address:
401 N UNION AVE
ROSWELL, NM
ZIP 88201
Phone: (575) 291-9814
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PECOS VALLEY WELLNESS LLC is a primary care clinic center in Roswell, NM. PECOS VALLEY WELLNESS LLC NPI is 1407382567. The provider is registered as an organization entity type.

The provider's business location address is:

401 N UNION AVE
ROSWELL, NM
ZIP 88201-948
Phone: (575) 291-9814
Fax: (575) 587-3987

The provider's authorized official is Stephen Wayne Muhr .
The authorized official title is Owner/provider and has the following contact phone number (575) 291-9814.

The CLIA number assigned to this NPI record is 32D2116788 - practitioner other with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 5/11/2017 and was last updated on 5/11/2017.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	261QP2300X	Clinic/Center	Primary Care	PA2009-0030	NEW MEXICO	Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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