Provider Demographics
NPI:1396129581
Name:ASPEN MEDICAL CENTER LLC
Entity type:Organization
Organization Name:ASPEN MEDICAL CENTER LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OPERATIONS MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:JOANNA
Authorized Official - Middle Name:
Authorized Official - Last Name:ANAYA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:505-466-5885
Mailing Address - Street 1:411 S SANTA CLARA BRIDGE RD
Mailing Address - Street 2:
Mailing Address - City:ESPANOLA
Mailing Address - State:NM
Mailing Address - Zip Code:87532-9477
Mailing Address - Country:US
Mailing Address - Phone:505-747-6939
Mailing Address - Fax:505-466-5886
Practice Address - Street 1:411 S SANTA CLARA BRIDGE RD
Practice Address - Street 2:
Practice Address - City:ESPANOLA
Practice Address - State:NM
Practice Address - Zip Code:87532-9477
Practice Address - Country:US
Practice Address - Phone:505-747-6939
Practice Address - Fax:505-466-5886
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-07-17
Last Update Date:2017-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent CareGroup - Single Specialty