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
626 TAFT STREET, COLUMBUS, NM 88029-0690
(575) 531-2165
(575) 531-2172
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
6755
NM
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
321871
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
T9358
—
NM
Enumeration date
07/11/2006
Last updated
10/05/2010
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