Village of Fort Sumner
Organization Active NPI Ambulance · Ft Sumner, NM
NPI 1356470447 · NPPES record last updated Nov 7, 2013
Key facts
- NPI
- 1356470447
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Ambulance 341600000X
- Legal business name
- VILLAGE OF FORT SUMNER
- Practice address
- 173 E Ave C
Ft Sumner, NM 88119 - Phone
- (575) 355-2401
- NPI assigned
- Mar 5, 2007
- Organization subpart
- No
Authorized official
- Name
- Bonnie Lilly
- Title
- Administrator
- Phone
- (575) 355-2401
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NM
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20100208000081 | NM | Part B Supplier - Ambulance Service Supplier | 4284777657 | Practice locations: Fort Sumner, NM |
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Ambulance | 341600000X | Yes |
Addresses
Primary practice location
173 E Ave C
Ft Sumner, NM 88119
Mailing address
PO Box 180
Fort Sumner, NM 88119-0180
Phone (575) 355-2401
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| R4656 | Medicaid | NM |
Other names
- FT SUMNER AMBULANCE
Other providers in Ft Sumner, NM
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 7, 2013. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.