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General NPI Number Information
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NPI Number | 1538286521
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Entity Type | Organization
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Legal Business Name | EGIS-ELDERS GETTING INFORMATION AND SERVICES
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Dates
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Enumeration Date | 03/23/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 227 E PALACE AVE
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City | SANTA FE
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State | NM
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Zip | 87501-2043
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Country | US
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Telephone | 505-995-0485
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Fax | 505-986-8581
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Provider Business Mailing Address
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Address Line | PO BOX 8132
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City | SANTA FE
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State | NM
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Zip | 87504-8132
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Country | US
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Telephone | 505-995-0485
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Fax | 505-986-8581
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | MR. JEFFREY SMITH PINE
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Credential | MSPH, CMC, MS
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Telephone | 505-995-0485
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 171M00000X
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Taxonomy Name | Case Manager/Care Coordinator
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License Number |
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License Number State | NM
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