Organization
PRESBYTERIAN HEALTHCARE SERVICES
Active
Other names
Colfax General Laboratory
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ROBERT GARCIA (VP REGIONAL OPERATIONS)
(505) 923-5339
Entity
Organization
Contact information
Practice address
615 PROSPECT AVE, SPRINGER, NM 87747
(505) 483-3310
(505) 483-3327
Mailing address
PO BOX 458, SPRINGER, NM 87747-0458
(505) 483-3302
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
—
—
207R00000X
Internal Medicine Physician
—
—
261QH0100X
Health Service Clinic/Center
Primary
2005-089
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
07726511
—
NM
01
—
500521006
MEDICRE PARE B
NM
Enumeration date
12/20/2005
Last updated
08/08/2010
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