Organization
PRESBYTERIAN MEDICAL SERVICES
Active
Other names
CUBA HEALTH CENTER
Organization subpart
No
Provider details
NPI number
Authorized official
DOUG SMITH (EXECUTIVE VICE PRESIDENT)
(505) 982-5565
Entity
Organization
Contact information
Practice address
6349 US HWY 550, CUBA, NM 87013
(505) 289-3291
(505) 289-3648
Mailing address
PO BOX 2267, SANTA FE, NM 87504-2267
Taxonomy
Speciality
Code
Description
License number
State
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
6002
NM
332900000X
Non-Pharmacy Dispensing Site
CL00007158
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3209574
OTHER ID NUMBER
—
05
—
47209
—
NM
Enumeration date
08/15/2006
Last updated
01/09/2021
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