Organization
PRESBYTERIAN HEALTHCARE SERVICES
Active
Other names
Clovis Swing Bed SNF
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MARK REIFSTECK (SR VP CHIEF OPERATING OFFICER)
(505) 841-1392
Entity
Organization
Contact information
Practice address
2200 W 21ST ST, CLOVIS, NM 88101-2011
(505) 469-7577
(505) 769-7595
Mailing address
PO BOX 26666, PROVIDER ENROLLMENT, ALBUQUERQUE, NM 87125-6666
(505) 823-8528
(505) 823-8555
Taxonomy
Speciality
Code
Description
License number
State
275N00000X
Medicare Defined Swing Bed Hospital Unit
Primary
59304
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2251701
PART B
NM
Enumeration date
12/19/2005
Last updated
08/22/2020
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