| Organization Name: | PECOS VALLEY MEDICAL CENTER, INC |
| NPI Number: | 1497801047 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | KEVIN NORRIS (CFO) |
| Mailing Address: | 199 Hwy 50 Pecos |
| State: | NM US |
| Postal Code: | 875520710 |
| Phone Number: | 5057576482 |
| Fax Number: | 5057572700 |
| NPI Enumeration Date: | 01/26/2007 |
| NPI Last Update Date: | 09/22/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 3336C0002X |
| License Number: | CL00007120 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | NM |
| Taxonomy Type: | Suppliers |
| Taxonomy Classification: | Pharmacy |
| Taxonomy Specialization: | Clinic Pharmacy |
| Taxonomy Definition: | A pharmacy in a clinic, emergency room or hospital (outpatient) that dispenses medications to patients for self-administration under the supervision of a pharmacist. |