Organization
PRESBYTERIAN MEDICAL SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DOUG SMITH (EXECUTIVE VICE PRESIDENT)
(505) 982-5565
Entity
Organization
Contact information
Practice address
835 SPRUCE ST, C & D, ESPANOLA, NM 87532-3455
(505) 747-7400
(505) 747-7403
Mailing address
PO BOX 2267, SANTA FE, NM 87504-2267
(505) 982-5565
(505) 992-4990
Taxonomy
Speciality
Code
Description
License number
State
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
88855520
—
NM
Enumeration date
12/10/2009
Last updated
01/09/2021
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