| Organization Name: | DEPARTMENT OF HEALTH, PUBLIC HEALTH DIVISION |
| NPI Number: | 1629228697 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | DEBRA LOPEZ (CLAIMS MANAGER) |
| Mailing Address: | 1190 S Saint Francis Dr S1073 Santa Fe |
| State: | NM US |
| Postal Code: | 875054173 |
| Phone Number: | 5058270664 |
| Fax Number: | 5058272329 |
| NPI Enumeration Date: | 09/25/2008 |
| NPI Last Update Date: | 09/25/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 251K00000X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Agencies |
| Taxonomy Classification: | Public Health or Welfare |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |