Western Nm Med Group Gallop

LBN: Presbyterian Medical Services
Western Nm Med Group Gallop is an health care organization with primary practice located at 610 N 5Th St , Gallup NM 87301-5306. The organization recently has 2 registered licenses in different health care specialties including Ambulatory Health Care Facilities / Federally Qualified Health Center (FQHC), Suppliers / Non-Pharmacy Dispensing Site. Ambulatory Health Care Facilities / Federally Qualified Health Center (FQHC) is the primary health care specialty. Presbyterian Medical Services can be contacted via phone (505) 863-3120, or through Lee, Roberta via phone (505) 982-5565.

Contact Information

Primary practice address
610 N 5Th St Gallup NM 87301-5306
Fax: (505) 863-2961
Website:
Authorized official contact:
Name: Lee, Roberta

Health care specialties

SpecialtyCodeLicense #State
Ambulatory Health Care Facilities / Federally Qualified Health Center (FQHC) 261QF0400X New Mexico
Suppliers / Non-Pharmacy Dispensing Site 332900000X CL00007461 New Mexico

Profile Details

NPI number 1972670305
LBN Legal business name Presbyterian Medical Services
DBA Doing business as Western Nm Med Group Gallop
Authorized official Lee, Roberta
Entity Organization
Organization subpart 1 No
Enumeration date Nov 29th, 2006
Last updated Jul 21st, 2022 - about 4 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 1972670305 NPPES
Other 3209675 OTHER ID NUMBER
MEDICAID 50526 OTHER ID NUMBER

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