PECOS VALLEY MEDICAL CENTER, INC (NPI# 1386143352) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1386143352 |
| Entity Type | Organization |
| Organization Name | PECOS VALLEY MEDICAL CENTER, INC |
| Other Organization Name | PECOS VALLEY MEDICAL CENTER, INC TEEN SCHOOL BASED CLINIC |
| Practice Address |
North Highway 63 Panther Parkway Pecos NM 87552 |
| Mailing Address |
Po Box 710 Pecos NM 87552-0710 |
| Practice Telephone | 5057576482 |
| Practice Fax Number | 5057572700 |
| Mailing Telephone | 5057577120 |
| Mailing Fax Number | 5057572700 |
| Enumeration Date | 2018-02-06 |
| Last Update Date | 2018-02-06 |
| Authorized Official Name | ALBERTO LOPEZ (FACILITY MANAGER) |
| Authorized Official Telephone | 5057577120 |
| Is Organization Subpart | Y |
| Parent Organization Name | PECOS VALLEY MEDICAL CENTER, INC |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QS1000X |
Clinic/Center Specialization: Student Health |
PENDING | NM | Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| PECOS VALLEY MEDICAL CENTER, INC TEEN SCHOOL BASED CLINIC | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497801047 | Pecos Valley Medical Center, Inc | Pharmacy | 199 Hwy 50, Pecos, NM 87552-0710 | 2007-01-26 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | PECOS VALLEY MEDICAL CENTER, INC. | 199 Hwy 50, Pecos, NM 87552 |
| Street Address |
NORTH HIGHWAY 63 PANTHER PARKWAY |
| City | PECOS |
| State | NM |
| Zip Code | 87552 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710028485 | Nathan Pack | Occupational Therapist | North Highway 63, Pecos, NM 87552-0368 | 2007-02-08 |
| 1528574407 | Pamela Ortiz | Registered Nurse | North Highway 63, Pecos, NM 87552-8755 | 2017-12-14 |
| 1700091311 | Tara Tricia Eldridge | Social Worker | North Highway 63, Pecos, NM 87552 | 2007-05-14 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083262422 | Presbyterian Medical Services | Clinic/Center | 28 Panther Parkway, 63 North Highway, Pecos, NM 87552 | 2019-08-29 |
| 1437653060 | Caitlin Thomas | Nurse Practitioner | Pecos Valley Medical Center 199 Hwy 50, Pecos, NM 87552 | 2018-03-20 |
| 1609393636 | Graciella Liliana Valencia-varela | Behavior Technician | #03 West Chamisa Spur, 03, Pecos, NM 87552 | 2017-08-30 |
| 1497146690 | Scott Temple | Social Worker | 199 Nm Highway 50, Pecos, NM 87552 | 2015-02-10 |
| 1750671954 | Julastene Dyer-moore | Dentist | 199 Highway 50, Pecos, NM 87552 | 2011-04-10 |
| 1316267073 | Lida Valencia | Counselor | 199 Nm-50, Pecos, NM 87552 | 2010-06-04 |
| 1801927264 | Pecos Independent School District | Local Education Agency (LEA) | Pecos Independent School District, North Highway 63, Pecos, NM 87552 | 2007-03-08 |
| 1629150610 | Susan Upton Lovro | Physician Assistant | 3 Highway 50, #d, Pecos, NM 87552 | 2006-10-19 |
| 1730150178 | Lucien David Young | Internal Medicine | 199 Nm Hwy 50, Pecos, NM 87552 | 2006-02-01 |
| 1487291464 | Susan Sheldon Olive | Physician Assistant | 199 Highway 50, Pecos, NM 87552 | 2019-12-09 |
| Find all providers in zip 87552 | ||||
| Taxonomy Code | 261QS1000X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Student Health |
| Definition to come... |
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| 1720305188 | West Las Vegas Public Schools | Clinic/Center | 1024 South Pacific, Las Vegas, NM 87701-3495 | 2010-04-26 |
| 1801021670 | Communtiy Action Agency of Southern N.m., Inc. | Clinic/Center | 1301 Washington St., Anthony, NM 88021-8846 | 2009-05-22 |
| 1114161510 | Dulce Independent Schools | Clinic/Center | 125 Hawks Dr, Dulce, NM 87528-0547 | 2009-04-29 |
| 1245470061 | The Community Foundation of Southern New Mexico | Clinic/Center | 1755 El Paseo, Las Cruces High School - Based Health Center, Las Cruces, NM 88011 | 2009-03-06 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.