# STATE OF NEW MEXICO

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Other names:** DOH/PHD/Immunization Program
- **Organization subpart:** No

## Provider details

- **NPI number:** 1972784544
- **Authorized official:** SANDRA E. MARTINEZ (DEPUTY DIRECTOR, FINANCE AND ADMINI)
- **Authorized official phone:** (505) 827-2389

## Contact information

- **Practice address:** 605 LETRADO, SANTA FE, NM 87505
- **Practice address phone:** (505) 476-2600
- **Practice address fax:** (505) 476-2692
- **Mailing address:** PO BOX 26110, 1190 ST. FRANCIS DRIVE, SANTA FE, NM 87502-6110
- **Mailing address phone:** (505) 827-2389
- **Mailing address fax:** (505) 827-2329

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 251K00000X | Public Health or Welfare Agency | — | NULL | Yes |

## Other

- **Enumeration date:** 11/23/2007
- **Last updated:** 01/06/2016