Provider Demographics
NPI:1053952473
Name:HEALTHNM, LLC
Entity type:Organization
Organization Name:HEALTHNM, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN/FOUNDER/CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:LILIA
Authorized Official - Middle Name:MARGARITA
Authorized Official - Last Name:PEDREGO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:505-453-4590
Mailing Address - Street 1:701 OSUNA RD NE STE 600
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87113-0009
Mailing Address - Country:US
Mailing Address - Phone:505-404-0295
Mailing Address - Fax:
Practice Address - Street 1:701 OSUNA RD NE STE 600
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87113-0009
Practice Address - Country:US
Practice Address - Phone:505-404-0295
Practice Address - Fax:505-521-5157
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-10-07
Last Update Date:2024-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NM99131013Medicaid