Provider Demographics
NPI:1497462592
Name:PMS PRESBYTERIAN MEDICAL SERVICES
Entity Type:Organization
Organization Name:PMS PRESBYTERIAN MEDICAL SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COMMUNITY SUPPORT WORKER - CHILDREN
Authorized Official - Prefix:
Authorized Official - First Name:LUIS
Authorized Official - Middle Name:H
Authorized Official - Last Name:FUENTES
Authorized Official - Suffix:
Authorized Official - Credentials:CSW
Authorized Official - Phone:575-437-7404
Mailing Address - Street 1:2360 INDIAN WELLS RD
Mailing Address - Street 2:
Mailing Address - City:ALAMOGORDO
Mailing Address - State:NM
Mailing Address - Zip Code:88310-4609
Mailing Address - Country:US
Mailing Address - Phone:575-437-7404
Mailing Address - Fax:575-439-2860
Practice Address - Street 1:2360 INDIAN WELLS RD
Practice Address - Street 2:
Practice Address - City:ALAMOGORDO
Practice Address - State:NM
Practice Address - Zip Code:88310-4609
Practice Address - Country:US
Practice Address - Phone:575-437-7404
Practice Address - Fax:575-439-2860
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-10-31
Last Update Date:2022-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171M00000XOther Service ProvidersCase Manager/Care CoordinatorGroup - Single Specialty