MEDICARE: PECOS VALLEY REGIONAL EDUCATION COOP 8

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
1	251S00000X	Community/Behavioral Health Agency
2	251300000X	Local Education Agency (LEA)

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1366597908
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PECOS VALLEY REGIONAL EDUCATION COOP 8

Provider Business Mailing Address
First Line	:	PO BOX 155
Second Line	:
City	:	ARTESIA
State	:	NM
Zip	:	88211-0155
Country	:	US
Telephone Number	:	575-748-6100
Fax Number	:	575-748-6160

Provider Business Practice Location Address
First Line	:	2218 W GRAND AVE
Second Line	:
City	:	ARTESIA
State	:	NM
Zip	:	88210
Country	:	US
Telephone Number	:	575-748-6100
Fax Number	:	575-748-6160

Authorized Official
Title or Position	:	DIRECTOR
Name	:	MRS. LENA CHAVEZ
Credential	:
Telephone Number	:	575-748-6199

Provider Enumeration Date	:	01/24/2007
Last Update Date	:	02/26/2008

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Directions to “PECOS VALLEY REGIONAL EDUCATION COOP 8 ” Practice Location

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