| Organization Name: | PRESBYTERIAN MEDICAL SERVICES |
| NPI Number: | 1760540553 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | ROBERTA LEE (CFO) |
| Mailing Address: | 8 Old Town Loop Quemado |
| State: | NM US |
| Postal Code: | 87829 |
| Phone Number: | 5057734627 |
| Fax Number: | |
| NPI Enumeration Date: | 12/05/2006 |
| NPI Last Update Date: | 02/06/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QF0400X |
| License Number: | 32D0887987 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NM |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Federally Qualified Health Center (FQHC) |
| Taxonomy Definition: | |