Healthcare Provider Details

I. General information

NPI: 1811233927
Provider Name (Legal Business Name): PRESBYTERIAN HEALTHCARE SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/17/2012
Last Update Date: 12/17/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7920 CARMEL AVE NE
ALBUQUERQUE NM
87122-2966
US

IV. Provider business mailing address

PO BOX 26666
ALBUQUERQUE NM
87125-6666
US

V. Phone/Fax

Practice location:
  • Phone: 505-828-4789
  • Fax: 505-828-4989
Mailing address:
  • Phone: 505-923-5355
  • Fax: 505-923-5354

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QU0200X
TaxonomyUrgent Care Clinic/Center
License Number6022
License Number StateNM

VIII. Authorized Official

Name: LAUREN CATES
Title or Position: SVP-PDS MARKET DEV/OPS PLAN
Credential:
Phone: 505-923-5432