OrganizationPrimary Care And Preventive Services, PcInternal MedicineAllopathic & Osteopathic PhysiciansPractice Address4710 Jefferson St NE, Albuquerque, NM 87109-2155(505) 883-1259PECOS EnrollmentBased on the most recent information from CMS, provider Primary Care And Preventive Services, Pc does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records 5 days ago.Profile DetailsProvider ID1558301903Provider TypeOrganizationFull NamePrimary Care And Preventive Services, PcSubpartNoEnumeration Date6/7/2006Last Updated2/27/2014Contact InformationPractice LocationPractice Address4710 Jefferson St NE, Albuquerque, NM 87109-2155Phone(505) 883-1259Fax(505) 883-3020Mailing LocationMailing Address4710 Jefferson St NE, Albuquerque, NM 87109-2155Phone(505) 883-1259Fax(505) 883-3020Authorized OfficialNameBryant, Matthew C (Office Manager)Phone(505) 883-1259Provider TaxonomiesCodeDescriptionLicenseCode207R00000XPrimaryDescriptionInternal MedicineAllopathic & Osteopathic PhysiciansLicense86-185New MexicoProvider IdentifiersIDDescriptionIssuerID202006617DescriptionOtherIssuerPRESBYTERIAN PINNew MexicoID975291DescriptionOtherIssuerUNITED HEALTHCARE PINNew Mexico