Bethphage Mission West

LBN: Bethphage Mission West
Bethphage Mission West is an health care organization with primary practice located at 920 Lobo Canyon Rd Suite 5A, Grants NM 87020-2173. The organization recently has only one registered license in Other Service Providers / Specialist, which is considered as the primary health care specialty. Bethphage Mission West can be contacted via phone (505) 287-9333, or through Wilson, Dean via phone (402) 896-3884.

Contact Information

Primary practice address
920 Lobo Canyon Rd Suite 5A Grants NM 87020-2173
Phone: (505) 287-9333
Fax: (505) 287-9336
Website:
Map and Directions
Authorized official contact:
Name: Wilson, Dean
Phone: (402) 896-3884

Health care specialties

SpecialtyCodeLicense #State
Other Service Providers / Specialist 174400000X New Mexico

Profile Details

NPI number 1649482639
LBN Legal business name Bethphage Mission West
DBA Doing business as
Authorized official Wilson, Dean
Entity Organization
Organization subpart 1 No
Enumeration date May 4th, 2007
Last updated Aug 22nd, 2020 - about 6 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1649482639 NPPES
New Mexico MEDICAID D0103

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