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Presbyterian Healthcare Services

Organization Active NPI Critical Access Hospital · Tucumcari, NM

NPI 1235115676 · NPPES record last updated Aug 9, 2010

Key facts

NPI
1235115676
Entity type
Organization (NPI type 2)
Primary specialty
Critical Access Hospital 282NC0060X
License
3011 (NM)
Legal business name
PRESBYTERIAN HEALTHCARE SERVICES
Practice address
301 E Miel de Luna Ave
Tucumcari, NM 88401-3810
Phone
(505) 461-0141
Fax
(505) 461-1822
NPI assigned
Dec 19, 2005
Organization subpart
No

Authorized official

Name
Mr. Robert Garcia
Title
VP Regional Operations
Phone
(505) 923-5339

Corporate family (same tax ID) 24

Organizations that report the same tax identification number in the National Provider Directory.

Facilities connected through Provider of Services related, parent or unit certification numbers.

Facilities with the same owner 8

Facilities that share an organizational owner with 5% or greater ownership or operational control.

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

Affiliated clinicians 1

Clinicians who list this facility as an affiliation in Medicare Care Compare.

Medicare participation

Medicare fee-for-service enrollment
Enrolled in NM

Hospital certification: CCN 32Z302

Legal name
PRESBYTERIAN HEALTHCARE SERVICES
Doing business as
DR. DAN C. TRIGG MEMORIAL HOSPITAL
Organization structure
Other · Non-profit
Incorporated
in NM
Enrollment address
301 E Miel de Luna
Dr. Dan C. Trigg Memorial Hospital
Tucumcari, NM 88401-3810
Other Hospital Practice Location

All disclosed owners & managing parties 4

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Kimberly Poland
Individual 		W-2 Managing Employee
Manager Provider Enrollment		 Jan 1, 2011
Dale Maxwell
Individual 		W-2 Managing Employee
President Ceo		 Jan 1, 2011
Operational/Managerial Control
President Ceo		 Jan 1, 2011
Steven Figge
Individual 		Corporate Director
Director of Mso		 Jan 1, 2010
W-2 Managing Employee
Director of Mso		 Jan 1, 2010
Presbyterian Healthcare Services
Organization · Tucumcari, NM
Non-profit 		Operational/Managerial Control Mar 15, 2000

All facility ownership & control disclosures 8

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Presbyterian Espanola Hospital
Espanola, NM · CCN 320011		 Hospital Operational/Managerial Control May 24, 1948
Plains Regional Medical Center Clovis
Clovis, NM · CCN 320022		 Hospital Operational/Managerial Control Jan 1, 1978
Socorro General Hospital
Socorro, NM · CCN 32Z301		 Hospital Operational/Managerial Control Mar 30, 2000
Socorro General Hospital
Socorro, NM · CCN 321301		 Hospital Operational/Managerial Control Mar 30, 2000
Dr. Dan C. Trigg Memorial Hospital
Tucumcari, NM · CCN 321302		 Hospital Operational/Managerial Control Mar 30, 2000
Socorro General Hospital Home Healthcare
Socorro, NM · CCN 327027		 Home health agency 5% Or Greater Direct Ownership Interest
Operational/Managerial Control		 Apr 1, 2000
Jan 19, 2009
Plains Regional Medical Center Clovis Home Healthcare
Clovis, NM · CCN 327305		 Home health agency 5% Or Greater Direct Ownership Interest Feb 14, 1979
Tucumcari Hospice
Tucumcari, NM · CCN 321566		 Hospice 5% Or Greater Direct Ownership Interest
Operational/Managerial Control		 Dec 1, 2009
Dec 1, 2009

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20090305000600 NM Part a Provider - Critical Access Hospital 9234041708 Receives reassigned benefits from 1 practitioner
Practice locations: Tucumcari, NM

National Provider Directory

Tax ID family
Espanola Hospital Pharm (69 organizations share this tax ID)

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician
Group: 193200000X MULTI-SPECIALTY GROUP		 207P00000X
Internal Medicine Physician
Group: 193200000X MULTI-SPECIALTY GROUP		 207R00000X
Critical Access Hospital 282NC0060X 3011 NM Yes

Addresses

Primary practice location

301 E Miel de Luna Ave
Tucumcari, NM 88401-3810

Mailing address

PO Box 26666
Provider Enrollment
Albuquerque, NM 87125-6666
Phone (505) 923-5356

Other identifiers

IdentifierTypeStateIssuer
2255606OtherNMPART B

Other names

  • Dr dan C Trigg Swing Bed Doing business as

Other providers in Tucumcari, NM

All providers in Tucumcari, NM · Critical Access Hospital in New Mexico

Sources for this page

Verify at the official NPI Registry.