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NPI Code Detail

MEDICARE: PRESBYTERIAN MEDICAL SERVICES

MEDICARE: PRESBYTERIAN MEDICAL 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
1251C00000XDevelopmentally Disabled Services Day Training AgencyCU00006339NM

Other Identifiers

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

General Provider Information

NPI Number : 1972712875
Entity Type Code : Organization
Provider Name (Legal Business Name) : PRESBYTERIAN MEDICAL SERVICES
Provider Business Mailing Address
First Line : PO BOX 2267
Second Line :
City : SANTA FE
State : NM
Zip : 87504-2267
Country : US
Telephone Number : 505-820-3466
Fax Number : 505-992-4990
Provider Business Practice Location Address
First Line : 608 REILLY AVE
Second Line :
City : FARMINGTON
State : NM
Zip : 87401-2634
Country : US
Telephone Number : 505-325-8931
Fax Number : 505-326-7283
Authorized Official
Title or Position : EXEC. VP
Name : MR. DOUG SMITH
Credential :
Telephone Number : 505-982-5565
Provider Enumeration Date : 05/21/2007
Last Update Date : 04/07/2022

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Directions to “PRESBYTERIAN MEDICAL SERVICES ” Practice Location

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