Organization
PRESBYTERIAN MEDICAL SERVICES
Active
Other names
ESPERANZA FAMILY HEALTH CENTER
Organization subpart
No
Provider details
NPI number
Authorized official
ROBERTA LEE (CFO)
(505) 982-5565
Entity
Organization
Contact information
Practice address
903 C N 5TH ST, ESTANCIA, NM 87016
(505) 384-2777
(505) 384-2204
Mailing address
PO BOX 2267, SANTA FE, NM 87504-2267
Taxonomy
Speciality
Code
Description
License number
State
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
6348
NM
332900000X
Non-Pharmacy Dispensing Site
CL00007280
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3209790
OTHER ID NUMBER
—
05
—
48058
—
NM
Enumeration date
08/29/2006
Last updated
01/23/2014
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