Provider Demographics
NPI:1982275236
Name:MESQUITE CLINIC MANAGEMENT COMPANY LLC
Entity type:Organization
Organization Name:MESQUITE CLINIC MANAGEMENT COMPANY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR REVENUE CYCLE
Authorized Official - Prefix:
Authorized Official - First Name:LAURA
Authorized Official - Middle Name:J
Authorized Official - Last Name:FEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:615-221-3641
Mailing Address - Street 1:PO BOX 26526
Mailing Address - Street 2:
Mailing Address - City:BELFAST
Mailing Address - State:ME
Mailing Address - Zip Code:04915-2016
Mailing Address - Country:US
Mailing Address - Phone:702-398-3621
Mailing Address - Fax:
Practice Address - Street 1:1925 WHIPPLE AVE STE 30
Practice Address - Street 2:
Practice Address - City:LOGANDALE
Practice Address - State:NV
Practice Address - Zip Code:89021-9934
Practice Address - Country:US
Practice Address - Phone:702-398-3621
Practice Address - Fax:702-398-3639
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-07-08
Last Update Date:2021-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR1300XAmbulatory Health Care FacilitiesClinic/CenterRural Health