Healthcare Provider Details

I. General information

NPI: 1669521282
Provider Name (Legal Business Name): TAOS HEALTH SYSTEMS INC HOLY CROSS HOSPITAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/10/2007
Last Update Date: 04/19/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

#24 HIGHWAY 73
PENASCO NM
87553-0205
US

IV. Provider business mailing address

1397 WEIMER RD
TAOS NM
87571-6253
US

V. Phone/Fax

Practice location:
  • Phone: 575-587-1833
  • Fax: 575-587-1918
Mailing address:
  • Phone: 575-751-8905
  • Fax: 575-751-3723

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QC1500X
TaxonomyCommunity Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MR. PATRICK E ROSE
Title or Position: SPECIAL PROJECTS
Credential:
Phone: 575-751-8905