Organization
CITY OF SOCORRO
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. RAVI BHASKER M.D. (MAYOR)
(505) 835-0240
Entity
Organization
Contact information
Practice address
111 SCHOOL OF MINES RD, SOCORRO, NM 87801-4533
(505) 835-3969
Mailing address
PO BOX K, SOCORRO, NM 87801-0329
(505) 835-0240
(505) 838-4027
Taxonomy
Speciality
Code
Description
License number
State
341600000X
Ambulance
Primary
SCC1575
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
590005059
PALMETTO GBA
NM
01
—
R090
BLUE CROSS BLUE SHIELD
NM
05
—
R1942
—
NM
Enumeration date
09/20/2006
Last updated
04/15/2010
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