Organization
NOR-LEA HOSPITAL DISTRICT
Active
Other names
Tatum Medical Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
DAVID B SHAW (CEO/ADMINISTRATION)
(575) 396-6611
Entity
Organization
Contact information
Practice address
310 N MAIN, TATUM, NM 88267-9802
(575) 398-2111
(575) 398-6112
Mailing address
1600 NORTH MAIN, LOVINGTON, NM 88260-2813
(575) 396-6611
(575) 396-1454
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
6260
NM
261QR1300X
Rural Health Clinic/Center
Primary
6260
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
45260
—
NM
Enumeration date
06/23/2006
Last updated
05/01/2014
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