| Presbyterian Medical Services | |
|
06b Main St Cerrillos NM 87010 | |
| (505) 470-6266 | |
| (505) 471-5861 |
| Full Name | Presbyterian Medical Services |
|---|---|
| Speciality | Clinic/Center |
| Location | 06b Main St, Cerrillos, New Mexico |
| Authorized Official Name and Position | Roberta Lee (CFO) |
| Authorized Official Contact | 5059825565 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Presbyterian Medical Services Po Box 2267 Santa Fe NM 87504-2267 Ph: () - | Presbyterian Medical Services 06b Main St Cerrillos NM 87010 Ph: (505) 470-6266 |
| NPI Number | 1811064827 |
|---|---|
| Provider Enumeration Date | 11/29/2006 |
| Last Update Date | 11/02/2011 |
| Medicare PECOS PAC ID | 2062324684 |
|---|---|
| Medicare Enrollment ID | O20100809000645 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1811064827 | NPI | - | NPPES |
| 3209803 | Other | OTHER ID NUMBER | |
| F4919 | Medicaid | NM |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | 6515 (New Mexico) | Primary |
| 332900000X | Non-pharmacy Dispensing Site | CL00007440 (New Mexico) | Secondary |