Jicarilla EMS
Organization Active NPI Land Ambulance · Dulce, NM
NPI 1477684447 · NPPES record last updated Feb 21, 2013
Key facts
- NPI
- 1477684447
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Land Ambulance 3416L0300X
- License
- 47495 (NM)
- Legal business name
- JICARILLA EMS
- Practice address
- 2300 Narrow Gauge Rd
Dulce, NM 87528 - Phone
- (575) 759-3778
- Fax
- (575) 759-3841
- NPI assigned
- Mar 8, 2007
- Organization subpart
- Yes
- Parent organization (as reported)
- JUCARILLA EMS
Authorized official
- Name
- Mrs. Dawn Burns
- Title
- Acting Director
- Phone
- (575) 759-3778
Corporate family (same tax ID) 1
National Provider Directory
- Tax ID family
- Jicarilla EMS
- Part of
- Jicarilla EMS
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Land Ambulance | 3416L0300X | 47495 | NM | Yes |
Addresses
Primary practice location
2300 Narrow Gauge Rd
Dulce, NM 87528
Mailing address
Pob 769
2300 Narrow Gauge Rd
Dulce, NM 87528
Phone (575) 759-3778
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| R134 | Other | NM | BLUE CROSS BLUE SHIELD |
| R2939 | Medicaid | NM |
Other providers in Dulce, NM
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 21, 2013. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.