Provider Demographics
NPI:1851333421
Name:PRESBYTERIAN MEDICAL SERVICES INC
Entity Type:Organization
Organization Name:PRESBYTERIAN MEDICAL SERVICES INC
Other - Org Name:DEMING HEALTH CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:
Authorized Official - Last Name:RIEBSOMER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:505-982-5565
Mailing Address - Street 1:PRESBYTERIAN MEDICAL SVCS INC
Mailing Address - Street 2:PO BOX 2267
Mailing Address - City:SANTA FE
Mailing Address - State:NM
Mailing Address - Zip Code:87504
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:205 E HEMLOCK ST
Practice Address - Street 2:
Practice Address - City:DEMING
Practice Address - State:NM
Practice Address - Zip Code:88030-3734
Practice Address - Country:US
Practice Address - Phone:505-546-4663
Practice Address - Fax:505-546-4844
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-11
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
332900000X
NMCL00010267333600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered332900000XSuppliersNon-Pharmacy Dispensing Site
Not Answered333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
3211125OtherOTHER ID NUMBER-COMMERCIAL NUMBER