Petroglyph Primary Care

LBN: Petroglyph Primary Care And Consulting Llc
Petroglyph Primary Care is an health care organization with primary practice located at 525 Chavez St , Las Vegas NM 87701-3221. The organization recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Primary Care, which is considered as the primary health care specialty. Petroglyph Primary Care And Consulting Llc can be contacted via phone (505) 819-8434, or through Archuleta, Michael M via phone (505) 502-4401.

Contact Information

Primary practice address
525 Chavez St Las Vegas NM 87701-3221
Phone: (505) 819-8434
Fax:
Website:
Map and Directions
Authorized official contact:
Name: Archuleta, Michael M DNP, APRN, AGACNP-BC
Phone: (505) 502-4401

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Primary Care 363LP2300X

Profile Details

NPI number 1891578340
LBN Legal business name Petroglyph Primary Care And Consulting Llc
DBA Doing business as Petroglyph Primary Care
Authorized official Archuleta, Michael M DNP, APRN, AGACNP-BC
Entity Organization
Organization subpart 1 No
Enumeration date Aug 17th, 2023
Last updated Jan 13th, 2024 - about 2 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

Request for update

Identifiers

StateTypeNumberIssuer
All States NPI 1891578340 NPPES
New Mexico MEDICAID 70802777

Popular Providers