Healthcare Provider Details

I. General information

NPI: 1235948803
Provider Name (Legal Business Name): OTERO COUNTY HOSPITAL ASSOCIATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/07/2025
Last Update Date: 01/07/2025
Certification Date: 01/07/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

675 10TH ST
ALAMOGORDO NM
88310-6769
US

IV. Provider business mailing address

2669 SCENIC DR
ALAMOGORDO NM
88310-8700
US

V. Phone/Fax

Practice location:
  • Phone: 575-434-4130
  • Fax: 575-439-9757
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: BASHAR NASER
Title or Position: CHIEF FINANCIAL/OPERATIONS OFFICER
Credential:
Phone: 575-443-7848