MEDICARE: PRESBYTERIAN HEALTHCARE SERVICES

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	207P00000X	Emergency Medicine Physician
2	207R00000X	Internal Medicine Physician
3	314000000X	Skilled Nursing Facility

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1982689865
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PRESBYTERIAN HEALTHCARE SERVICES

Provider Business Mailing Address
First Line	:	PO BOX 26666
Second Line	:
City	:	ALBUQUERQUE
State	:	NM
Zip	:	87125-6666
Country	:	US
Telephone Number	:	505-923-5356
Fax Number	:	505-923-5354

Provider Business Practice Location Address
First Line	:	8300 CONSTITUTION AVE NE
Second Line	:
City	:	ALBUQUERQUE
State	:	NM
Zip	:	87110-7613
Country	:	US
Telephone Number	:	505-291-2000
Fax Number	:	505-291-2834

Authorized Official
Title or Position	:	CFO PRESBYTERIAN DELIVERY SYSTEM
Name	:	MR. DALE MAXWELL
Credential	:
Telephone Number	:	505-923-5353

Provider Enumeration Date	:	12/13/2005
Last Update Date	:	11/22/2010

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Directions to “PRESBYTERIAN HEALTHCARE SERVICES ” Practice Location

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