Presbyterian Healthcare Services
Organization Active NPI Health Service Clinic/Center · Springer, NM
NPI 1114903374 · NPPES record last updated Aug 8, 2010
Key facts
- NPI
- 1114903374
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Health Service Clinic/Center 261QH0100X
- License
- 2005-089 (NM)
- Legal business name
- PRESBYTERIAN HEALTHCARE SERVICES
- Practice address
- 615 Prospect Ave
Springer, NM 87747 - Phone
- (505) 483-3300
- Fax
- (505) 483-3344
- NPI assigned
- Dec 20, 2005
- Organization subpart
- No
Authorized official
- Name
- Mr. Robert Garcia
- Title
- VP Regional Operations
- Phone
- (505) 923-5339
Corporate family (same tax ID) 16
Laboratory certificates & supplier records
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 32D2192029 | Colfax General Long Term Care | Certificate of waiver | Sep 2, 2026 |
National Provider Directory
- Tax ID family
- Espanola Hospital Pharm
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Emergency Medicine Physician |
207P00000X | |||
| Internal Medicine Physician |
207R00000X | |||
| Health Service Clinic/Center | 261QH0100X | 2005-089 | NM | Yes |
Addresses
Primary practice location
615 Prospect Ave
Springer, NM 87747
Mailing address
PO Box 26666
Provider Enrollment
Albuquerque, NM 87125-6666
Phone (505) 923-5356
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| I 0274 | Medicaid | NM |
Other names
- Colfax Long Term Care
Other providers in Springer, NM
- Brandon McAfee
- Merced-LLC Merced Counseling Services
- Angelica Montoya
- Margaret Montoya
- Barbara Pattison-Martinez
- Presbyterian Healthcare Services
- Rebecca Ramirez
- Anthony Ramos
- Estevan Antonio Romero
- South Central Colfax County Special Hospital District
All providers in Springer, NM · Health Service Clinic/Center in New Mexico
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 8, 2010. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.