PRESBYTERIAN MEDICAL SERVICES NPI 1972670305

NPI Information

NPI: 1972670305
Provider Name: PRESBYTERIAN MEDICAL SERVICES

Doing Business As: WESTERN NM MED GROUP GALLOP

Classification: Clinic/Center - 261QF0400X
Entity Type: Organization

Specialization: Federally Qualified Health Center (FQHC)

Address:
610 N 5TH ST
GALLUP, NM
ZIP 87301
Phone: (505) 863-3120
Get Directions

PRESBYTERIAN MEDICAL SERVICES is a federally qualified health center (fqhc) clinic center in Gallup, NM. PRESBYTERIAN MEDICAL SERVICES NPI is 1972670305. The provider is registered as an organization entity type.
The provider Is Doing Business As Western Nm Med Group Gallop.

The provider's business location address is:

610 N 5TH ST
GALLUP, NM
ZIP 87301-306
Phone: (505) 863-3120
Fax: (505) 863-2961

The provider's authorized official is Roberta Lee .
The authorized official title is Cfo and has the following contact phone number (505) 982-5565.

The enumeration date for this NPI number is 11/29/2006 and was last updated on 7/21/2022.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	332900000X	Non-Pharmacy Dispensing Site		CL00007461	NEW MEXICO	No
2	261QF0400X	Clinic/Center	Federally Qualified Health Center (FQHC)		NEW MEXICO	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	3209675	OTHER		OTHER ID NUMBER
2	50526	MEDICAID	NEW MEXICO

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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