Provider Demographics
NPI:1164572533
Name:REHOBOTH MCKINLEY CHRISTIAN HEALTH CARE SERVICES
Entity Type:Organization
Organization Name:REHOBOTH MCKINLEY CHRISTIAN HEALTH CARE SERVICES
Other - Org Name:RMCHCS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:BILL
Authorized Official - Middle Name:
Authorized Official - Last Name:PATTEN
Authorized Official - Suffix:
Authorized Official - Credentials:CEO
Authorized Official - Phone:505-863-7001
Mailing Address - Street 1:1901 REDROCK DR
Mailing Address - Street 2:
Mailing Address - City:GALLUP
Mailing Address - State:NM
Mailing Address - Zip Code:87301-5683
Mailing Address - Country:US
Mailing Address - Phone:505-863-7000
Mailing Address - Fax:505-726-6708
Practice Address - Street 1:1901 REDROCK DR
Practice Address - Street 2:
Practice Address - City:GALLUP
Practice Address - State:NM
Practice Address - Zip Code:87301-5683
Practice Address - Country:US
Practice Address - Phone:505-863-7000
Practice Address - Fax:505-726-6708
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-10
Last Update Date:2024-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM6267332B00000X
332BD1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No332BD1200XSuppliersDurable Medical Equipment & Medical SuppliesDialysis Equipment & Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
NM00331Medicaid
NM43851Medicaid
NM4899430003OtherDME PROV NUMBER
NM46029Medicaid
NMN4841Medicaid
NMZ5147Medicaid
NM4899430003OtherDME PROV NUMBER
NM32-2309Medicare ID - Type UnspecifiedCRNPT DIALYSIS
NM32-3500Medicare ID - Type UnspecifiedZUNI DIALYSIS
NM43851Medicaid
NM46029Medicaid