| Eastern New Mexico Medical Center | |
|
405 W Country Club Rd Roswell NM 88201-5209 | |
| (505) 622-8170 | |
| (505) 624-8751 |
| Full Name | Eastern New Mexico Medical Center |
|---|---|
| Speciality | Psychiatry & Neurology - Psychiatry |
| Location | 405 W Country Club Rd, Roswell, New Mexico |
| Authorized Official Name and Position | Michael Portacci (GROUP VP) |
| Authorized Official Contact | 6154657000 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Eastern New Mexico Medical Center 405 W Country Club Rd Roswell NM 88201-5209 Ph: (505) 622-8170 | Eastern New Mexico Medical Center 405 W Country Club Rd Roswell NM 88201-5209 Ph: (505) 622-8170 |
| NPI Number | 1619902863 |
|---|---|
| Provider Enumeration Date | 07/12/2006 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1619902863 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | 2002-0076 (New Mexico) | Primary |
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Shekinah Foundation Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 3001 S Wyoming Ave, Roswell, NM 88203 Phone: 575-578-9450 | |
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