Provider Demographics
NPI:1306942958
Name:PACE MANAGEMENT, INC.
Entity type:Organization
Organization Name:PACE MANAGEMENT, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:EDDIE
Authorized Official - Middle Name:L
Authorized Official - Last Name:GAINES
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:505-522-6500
Mailing Address - Street 1:3800 E LOHMAN AVE
Mailing Address - Street 2:SUITE A
Mailing Address - City:LAS CRUCES
Mailing Address - State:NM
Mailing Address - Zip Code:88011-8273
Mailing Address - Country:US
Mailing Address - Phone:505-522-6500
Mailing Address - Fax:505-522-0591
Practice Address - Street 1:3800 E LOHMAN AVE
Practice Address - Street 2:SUITE A
Practice Address - City:LAS CRUCES
Practice Address - State:NM
Practice Address - Zip Code:88011-8273
Practice Address - Country:US
Practice Address - Phone:505-522-6500
Practice Address - Fax:505-522-0591
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-14
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM94250174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NM26189Medicaid
NMNM004123OtherBCBS NUMBER
NM=========OtherLOVELACE NO.
NMNM004123OtherBCBS NUMBER