# FORT BAYARD MEDICAL CENTER DEPARTMENT OF HEALTH

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1568821015
- **Authorized official:** MR. MARK BAILEY RPH (DIRECTOR OF PHARMACY)
- **Authorized official phone:** (575) 537-8745

## Contact information

- **Practice address:** 41 FORT BAYARD RD, SANTA CLARA, NM 88026-0293
- **Practice address phone:** (575) 537-8745
- **Practice address fax:** (575) 537-8897
- **Mailing address:** 41 FT BAYARD RD, SANTA CLARA, NM 88026
- **Mailing address phone:** (575) 537-8745
- **Mailing address fax:** (575) 537-8897

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 314000000X | Skilled Nursing Facility | RSD08058 | NM | Yes |

## Other

- **Enumeration date:** 02/12/2016
- **Last updated:** 02/12/2016