Provider Demographics
NPI:1215379284
Name:CENTRAL MEDICAL SERVICES OF SOUTHERN NEW MEXICO
Entity Type:Organization
Organization Name:CENTRAL MEDICAL SERVICES OF SOUTHERN NEW MEXICO
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:RICARDO
Authorized Official - Middle Name:
Authorized Official - Last Name:RUBIO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:575-524-8888
Mailing Address - Street 1:141 N ROADRUNNER PKWY STE 224
Mailing Address - Street 2:
Mailing Address - City:LAS CRUCES
Mailing Address - State:NM
Mailing Address - Zip Code:88011-2001
Mailing Address - Country:US
Mailing Address - Phone:575-524-8888
Mailing Address - Fax:575-524-8132
Practice Address - Street 1:141 N ROADRUNNER PKWY STE 224
Practice Address - Street 2:
Practice Address - City:LAS CRUCES
Practice Address - State:NM
Practice Address - Zip Code:88011-2001
Practice Address - Country:US
Practice Address - Phone:575-524-8888
Practice Address - Fax:575-524-8132
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-07-19
Last Update Date:2020-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
No2083X0100XAllopathic & Osteopathic PhysiciansPreventive MedicineOccupational MedicineGroup - Single Specialty