Organization
PRESBYTERIAN MEDICAL SERVICES
Active
Other names
Project Shield
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DOUG SMITH (EXEC. VP)
(505) 982-5565
Entity
Organization
Contact information
Practice address
608 REILLY AVE, FARMINGTON, NM 87401-2634
(505) 325-8931
(505) 326-7283
Mailing address
PO BOX 2267, SANTA FE, NM 87504-2267
(505) 820-3466
(505) 992-4990
Taxonomy
Speciality
Code
Description
License number
State
251C00000X
Developmentally Disabled Services Day Training Agency
Primary
CU00006339
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
D0834
—
NM
Enumeration date
05/21/2007
Last updated
04/07/2022
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