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NPI Code Detail

MEDICARE: PRESBYTERIAN HEALTHCARE SERVICES

MEDICARE: PRESBYTERIAN HEALTHCARE SERVICES
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207P00000XEmergency Medicine Physician
2207R00000XInternal Medicine Physician
3251E00000XHome Health Agency6624NM

General Provider Information

NPI Number : 1215912191
Entity Type Code : Organization
Provider Name (Legal Business Name) : PRESBYTERIAN HEALTHCARE SERVICES
Provider Business Mailing Address
First Line : PO BOX 26666
Second Line :
City : ALBUQUERQUE
State : NM
Zip : 87125-6666
Country : US
Telephone Number : 505-923-5356
Fax Number : 505-923-5354
Provider Business Practice Location Address
First Line : 1010 SPRUCE ST
Second Line :
City : ESPANOLA
State : NM
Zip : 87532-3456
Country : US
Telephone Number : 505-753-7111
Fax Number : 505-753-4438
Authorized Official
Title or Position : VP REGIONAL OPERATIONS
Name : MR. CLAY HOLDERMAN
Credential :
Telephone Number : 505-923-5339
Provider Enumeration Date : 12/13/2005
Last Update Date : 11/08/2016

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Directions to “PRESBYTERIAN HEALTHCARE SERVICES ” Practice Location

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These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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