Provider Demographics
NPI:1669521282
Name:TAOS HEALTH SYSTEMS INC HOLY CROSS HOSPITAL
Entity type:Organization
Organization Name:TAOS HEALTH SYSTEMS INC HOLY CROSS HOSPITAL
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:SPECIAL PROJECTS
Authorized Official - Prefix:MR
Authorized Official - First Name:PATRICK
Authorized Official - Middle Name:E
Authorized Official - Last Name:ROSE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:575-751-8905
Mailing Address - Street 1:1397 WEIMER RD
Mailing Address - Street 2:
Mailing Address - City:TAOS
Mailing Address - State:NM
Mailing Address - Zip Code:87571-6253
Mailing Address - Country:US
Mailing Address - Phone:575-751-8905
Mailing Address - Fax:575-751-3723
Practice Address - Street 1:#24 HIGHWAY 73
Practice Address - Street 2:
Practice Address - City:PENASCO
Practice Address - State:NM
Practice Address - Zip Code:87553-0205
Practice Address - Country:US
Practice Address - Phone:575-587-1833
Practice Address - Fax:575-587-1918
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-10
Last Update Date:2011-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QC1500XAmbulatory Health Care FacilitiesClinic/CenterCommunity Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NMS5239Medicaid
NM323996Medicare Oscar/Certification