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General NPI Number Information
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NPI Number | 1073517058
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Entity Type | Organization
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Legal Business Name | ROOSEVELT COUNTY SPECIAL HOSPITAL DISTRICT
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Dates
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Enumeration Date | 06/08/2005
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Last Update Date | 04/15/2019
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Provider Practice Location Address
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Address Line | 42121 US HIGHWAY 70
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City | PORTALES
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State | NM
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Zip | 88130-9357
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Country | US
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Telephone | 575-359-1800
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Fax | 575-356-9200
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Provider Business Mailing Address
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Address Line | PO BOX 868
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City | PORTALES
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State | NM
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Zip | 88130-0868
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Country | US
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Telephone | 575-359-1800
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Fax | 575-356-9200
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Authorized Official
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Title or Position | CHIEF FINANCIAL OFFICER
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Name | WILLIAM E BOYER
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Credential |
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Telephone | 575-356-3416
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 282N00000X
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Taxonomy Name | General Acute Care Hospital
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License Number | 3061
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License Number State | NM
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