# PRESBYTERIAN HEALTHCARE SERVICES

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Espanola Hospital
- **Organization subpart:** No

## Provider details

- **NPI number:** 1154307593
- **Authorized official:** MR. ROBERT GARCIA (VP REGIONAL OPERATIONS)
- **Authorized official phone:** (505) 923-5339

## Contact information

- **Practice address:** 1010 SPRUCE ST, ESPANOLA, NM 87532-3456
- **Practice address phone:** (505) 753-7111
- **Practice address fax:** (505) 753-4438
- **Mailing address:** PO BOX 26666, PROVIDER ENROLLMENT, ALBUQUERQUE, NM 87125-6666
- **Mailing address phone:** (505) 923-5356
- **Mailing address fax:** (505) 923-5354

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207P00000X | Emergency Medicine Physician | — | NULL | — |
| 207P00000X | Emergency Medicine Physician | — | — | — |
| 207R00000X | Internal Medicine Physician | — | NULL | — |
| 207R00000X | Internal Medicine Physician | — | — | — |
| 282NR1301X | Rural Acute Care Hospital | 6090 | NM | Yes |
| 3416L0300X | Land Ambulance | 6090 | NM | — |

## Other

- **Enumeration date:** 12/19/2005
- **Last updated:** 03/30/2010

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 00265 | — | NM |
| 01 | — | 2252104 | PART B | NM |