Provider Demographics
NPI:1346249968
Name:GUADALUPE COUNTY
Entity Type:Organization
Organization Name:GUADALUPE COUNTY
Other - Org Name:GUADALUPE COUNTY HOSPITAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:CHRISTINA
Authorized Official - Middle Name:
Authorized Official - Last Name:CAMPOS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:575-472-3417
Mailing Address - Street 1:117 CAMINO DE VIDA
Mailing Address - Street 2:100
Mailing Address - City:SANTA ROSA
Mailing Address - State:NM
Mailing Address - Zip Code:88435-2874
Mailing Address - Country:US
Mailing Address - Phone:575-472-3417
Mailing Address - Fax:575-472-4587
Practice Address - Street 1:117 CAMINO DE VIDA
Practice Address - Street 2:100
Practice Address - City:SANTA ROSA
Practice Address - State:NM
Practice Address - Zip Code:88435-2874
Practice Address - Country:US
Practice Address - Phone:575-472-3417
Practice Address - Fax:575-472-4587
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-07-15
Last Update Date:2023-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM6799282N00000X
282NR1301X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282NR1301XHospitalsGeneral Acute Care HospitalRural
No282N00000XHospitalsGeneral Acute Care Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
NM7230OtherNM DEPARTMENT OF HEALTH