Organization
STATE OF NEW MEXICO
Active
Parent organization
STATE OF NEW MEXICO
Other names
Medical Assistance Division
Organization subpart
Yes
Provider details
NPI number
Legal business name
STATE OF NEW MEXICO
Authorized official
ROBERT STEVENS RPH (CHIEF)
(505) 827-6207
Entity
Organization
Contact information
Practice address
2025 S PACHECO ST, SANTA FE, NM 87505-3991
(505) 827-3100
Mailing address
PO BOX 2348, SANTA FE, NM 87504-2348
(505) 827-3100
Taxonomy
Speciality
Code
Description
License number
State
251K00000X
Public Health or Welfare Agency
Primary
—
—
Other
Enumeration date
02/04/2008
Last updated
02/04/2008
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