Organization
PRESBYTERIAN HEALTHCARE SERVICES
Active
Organization
PRESBYTERIAN HEALTHCARE SERVICES
Active
Other names
Moreno Valley Healthcare Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ROBERT GARCIA (VP REGIONAL OPERATIONS)
(505) 923-5339
Entity
Organization
Contact information
Practice address
11 ELLIOTT BARKER LANE, ANGEL FIRE, NM 87710
(505) 337-3301
(505) 337-3991
Mailing address
PO BOX 26666, PROVIDER ENROLLMENT, ALBUQUERQUE, NM 87125-6666
(505) 923-5356
(505) 923-5354
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
—
—
207R00000X
Internal Medicine Physician
—
—
261Q00000X
Clinic/Center
Primary
2005510
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
Q7392
—
NM
Enumeration date
12/13/2005
Last updated
08/08/2010
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