# PHC LAS CRUCES

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- **Entity:** Organization
- **Status:** Active
- **Other names:** MMC Cancer Center
- **Organization subpart:** No

## Provider details

- **NPI number:** 1376774489
- **Authorized official:** ANGIE MANGUM (DIRECTOR)
- **Authorized official phone:** (575) 521-5277

## Contact information

- **Practice address:** 2530 S TELSHOR BLVD, SUITE 201, LAS CRUCES, NM 88011-4907
- **Practice address phone:** (575) 521-5277
- **Mailing address:** 2450 S TELSHOR BLVD, LAS CRUCES, NM 88011-5069
- **Mailing address phone:** (575) 521-5277

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207RH0003X | Hematology & Oncology Physician | — | NULL | Yes |
| 207RH0003X | Hematology & Oncology Physician | — | — | Yes |

## Other

- **Enumeration date:** 08/06/2009
- **Last updated:** 08/06/2009