Organization
BEN ARCHER HEALTH CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARY ALICE GARAY (EXECUTIVE DIRECTOR)
(575) 267-3280
Entity
Organization
Contact information
Practice address
125 CHAPARREL BLVD NW, DEMING, NM 88030-8629
(575) 546-4800
(575) 546-0685
Mailing address
PO BOX 370, HATCH, NM 87937-0370
(575) 267-3280
(575) 267-1747
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
3175
NM
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
321893
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
44403879
—
NM
Enumeration date
07/11/2006
Last updated
09/29/2010
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