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NPI Code Detail

MEDICARE: PRESBYTERIAN MEDICAL SERVICES

MEDICARE: PRESBYTERIAN MEDICAL SERVICES
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1174H00000XHealth Educator

General Provider Information

NPI Number : 1528710019
Entity Type Code : Organization
Provider Name (Legal Business Name) : PRESBYTERIAN MEDICAL SERVICES
Provider Business Mailing Address
First Line : PO BOX 2267
Second Line :
City : SANTA FE
State : NM
Zip : 87504-2267
Country : US
Telephone Number : 505-982-5565
Fax Number :
Provider Business Practice Location Address
First Line : 608 REILLY AVE
Second Line :
City : FARMINGTON
State : NM
Zip : 87401-2634
Country : US
Telephone Number : 505-326-6434
Fax Number :
Authorized Official
Title or Position : EXECUTIVE VICE PRESIDENT
Name : DOUG SMITH
Credential :
Telephone Number : 505-982-5565
Provider Enumeration Date : 01/25/2022
Last Update Date : 01/25/2022

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Directions to “PRESBYTERIAN MEDICAL SERVICES ” Practice Location

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