Healthcare Provider Details

I. General information

NPI: 1073134748
Provider Name (Legal Business Name): THREE CROSSES REGIONAL HOSPITAL LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/04/2020
Last Update Date: 04/16/2021
Certification Date: 04/16/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2560 SAMARITAN DRIVE
LAS CRUCES NM
88001
US

IV. Provider business mailing address

2560 SAMARITAN DRIVE
LAS CRUCES NM
88001
US

V. Phone/Fax

Practice location:
  • Phone: 800-421-8274
  • Fax: 575-592-2224
Mailing address:
  • Phone: 800-421-8274
  • Fax: 575-592-2224

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number
License Number State

VIII. Authorized Official

Name: MARIA G ORTIZ
Title or Position: DIRECTOR OF HIM
Credential:
Phone: 575-800-3868