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Blue Cross and Blue Shield of New Mexico fax number

(866) 290-7718

Network Services

Used for: Request to Establish or Revise a Non-Contracted Facility Record

Fax destination details

Department
Network Services
Purpose
Request to Establish or Revise a Non-Contracted Facility Record
Form
Non-Contracted Facility Record Form — Request to Establish or Revise a Non-Contracted Facility Record
Address
Blue Cross and Blue Shield of New Mexico, P.O. Box 660058, ATTN: Network Services, Dallas, TX 75266-0058
Voice phone
(505) 837-8800

Before you send

  • Confirm that this exact department handles your document or request.
  • Check the organization website or call its main line for the current fax number.
  • Include a cover sheet and any case, member, claim, or form reference required.
  • Keep the delivery confirmation with your submission records.

Complete the entire form; provide facility name, address, tax ID, TIN/EIN, and NPI as applicable. Attach IRS 147C and W-9 as needed. If adding multiple locations, attach a separate sheet. Mail to Blue Cross and Blue Shield of New Mexico, P.O. Box 660058, ATTN: Network Services, Dallas, TX 75266-0058; or fax to (505) 816-2688 or 1-866-290-7718.

Official form instructions are published as a downloadable file on the organization's website.

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