PROGRAMA MEDICO DEL NORTE, INC.

Clinic/Center — Emergency Care

Code: 261QE0002X

Clinic/Center — Public Health, State or Local

Code: 261QP0905X

Clinic/Center — Radiology

Code: 261QR0200X

Clinical Medical Laboratory

Code: 291U00000X

Pharmacy — Clinic Pharmacy

Code: 3336C0002X

Pharmacy — Community/Retail Pharmacy

Code: 3336C0003X