Provider Demographics
NPI:1316013402
Name:ROOSEVELT COUNTY SPECIAL HOSPITAL DISTRICT
Entity Type:Organization
Organization Name:ROOSEVELT COUNTY SPECIAL HOSPITAL DISTRICT
Other - Org Name:RGH INTERNAL MEDICINE GROUP
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:LORENCE
Authorized Official - Middle Name:
Authorized Official - Last Name:LEARNING
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:575-356-3412
Mailing Address - Street 1:42121 US HWY 70
Mailing Address - Street 2:
Mailing Address - City:PORTALES
Mailing Address - State:NM
Mailing Address - Zip Code:88130-0299
Mailing Address - Country:US
Mailing Address - Phone:575-359-1800
Mailing Address - Fax:575-356-9200
Practice Address - Street 1:42121 US HWY 70
Practice Address - Street 2:
Practice Address - City:PORTALES
Practice Address - State:NM
Practice Address - Zip Code:88130-9347
Practice Address - Country:US
Practice Address - Phone:575-359-1800
Practice Address - Fax:575-356-9200
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-28
Last Update Date:2015-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR1300XAmbulatory Health Care FacilitiesClinic/CenterRural Health