Organization
ROOSEVELT COUNTY SPECIAL HOSPITAL DISTRICT
Active
Other names
Roosevelt General Hospital
Organization subpart
No
Provider details
NPI number
Authorized official
WILLIAM E BOYER (CHIEF FINANCIAL OFFICER)
(575) 356-3416
Entity
Organization
Contact information
Practice address
42121 US HIGHWAY 70, PORTALES, NM 88130-9357
(575) 359-1800
(575) 356-9200
Mailing address
PO BOX 868, PORTALES, NM 88130-0868
(575) 359-1800
(575) 356-9200
Taxonomy
Speciality
Code
Description
License number
State
282N00000X
General Acute Care Hospital
Primary
3061
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
148185501
—
TX
05
—
148185502
—
TX
05
—
148185503
—
TX
01
—
17678
PRESBYTERIAN SALUD/HOSPIT
—
01
—
23587
LOVELACE SALUD/HOSPITAL
—
05
—
G8465
—
NM
05
—
G8765
—
NM
01
—
G8786
MEDICAID/PHYSICIANS
—
01
—
NM000077
BCBS/HOSPITAL
—
01
—
NM007684
BCBS/PHYSICIANS
—
Enumeration date
06/08/2005
Last updated
04/15/2019
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