STATE OF NEW MEXICO; NPI #1578075016

Contact Information

STATE OF NEW MEXICO

72 GAIL HARRIS ST
ROSWELL, NM 88203-8116

Phone: 575-347-3400
Fax: 575-347-5177
Website:

	Specialty	Taxonomy Code	Specialty Code	Provider Type
	Special Hospital	284300000X	A0[7]	Hospital-Specialty Hospital (cardiac, orthopedic, surgical)

Indicates primary specialty

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NPI Profile & details for STATE OF NEW MEXICO

NPI # 1578075016

LBN Legal business name STATE OF NEW MEXICO

Authorized official JOSE GURROLA - (ADMINISTRATOR)

Entity Organization

Organization subpart ¹ Yes

Enumeration date 10/24/2017

Last updated 10/24/2017 - About 9 years ago

Identifiers

NM	License #	6026
NM	Medicaid	0273

¹ Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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STATE OF NEW MEXICO

Contact Information

Specialty

Special Hospital

NPI Profile & details for STATE OF NEW MEXICO

Reviews for STATE OF NEW MEXICO