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Organization

STATE OF NEW MEXICO

Active
Other names
DOH/PHD/Immunization Program
Organization subpart
No

Provider details

NPI number
Authorized official
SANDRA E. MARTINEZ (DEPUTY DIRECTOR, FINANCE AND ADMINI)
(505) 827-2389
Entity
Organization

Contact information

Practice address
605 LETRADO, SANTA FE, NM 87505
(505) 476-2600
(505) 476-2692
Mailing address
PO BOX 26110, 1190 ST. FRANCIS DRIVE, SANTA FE, NM 87502-6110
(505) 827-2389
(505) 827-2329

Taxonomy

Speciality
Code
Description
License number
State
251K00000X
Public Health or Welfare Agency
Primary

Other

Enumeration date
11/23/2007
Last updated
01/06/2016
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