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Organization
PRESBYTERIAN HEALTHCARE SERVICES
Active
Organization
PRESBYTERIAN HEALTHCARE SERVICES
Active
Other names
Espanola Hospital
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ROBERT GARCIA (VP REGIONAL OPERATIONS)
(505) 923-5339
Entity
Organization
Contact information
Practice address
1010 SPRUCE ST, ESPANOLA, NM 87532-3456
(505) 753-7111
(505) 753-4438
Mailing address
PO BOX 26666, PROVIDER ENROLLMENT, ALBUQUERQUE, NM 87125-6666
(505) 923-5356
(505) 923-5354
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
—
NULL
207P00000X
Emergency Medicine Physician
—
—
207R00000X
Internal Medicine Physician
—
NULL
207R00000X
Internal Medicine Physician
—
—
282NR1301X
Rural Acute Care Hospital
Primary
6090
NM
3416L0300X
Land Ambulance
6090
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00265
—
NM
01
—
2252104
PART B
NM
Enumeration date
12/19/2005
Last updated
03/30/2010
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