Organization
PRESBYTERIAN HEALTHCARE SERVICES
Active
Organization
PRESBYTERIAN HEALTHCARE SERVICES
Active
Parent organization
PRESBYTERIAN HEALTHCARE SERVICE
Other names
Lincoln County Medical Center ICF
Organization subpart
Yes
Provider details
NPI number
Legal business name
PRESBYTERIAN HEALTHCARE SERVICE
Authorized official
KIMBERLY T POLAND (MANAGER, PROVIDER ENROLLMENT)
(505) 923-5355
Entity
Organization
Contact information
Practice address
211 SUDDERTH DR, RUIDOSO, NM 88345-6002
(575) 257-8200
(575) 630-4237
Mailing address
PRESBYTERUAN PROVIDER ENROLLMENT, PO BOX 26666, ALBUQUERQUE, NM 87125-6666
(505) 923-5356
(505) 923-5354
Taxonomy
Speciality
Code
Description
License number
State
275N00000X
Medicare Defined Swing Bed Hospital Unit
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000521
—
NM
Enumeration date
04/15/2020
Last updated
04/15/2020
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