Village of Des Moines
Organization Active NPI Land Ambulance · Des Moines, NM
NPI 1508182007 · NPPES record last updated Apr 9, 2010
Key facts
- NPI
- 1508182007
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Land Ambulance 3416L0300X
- Legal business name
- VILLAGE OF DES MOINES
- Practice address
- 77 North Olive St
Des Moines, NM 88418 - Phone
- (575) 278-3911
- Fax
- (575) 278-2106
- NPI assigned
- Apr 9, 2010
- Organization subpart
- No
Authorized official
- Name
- Mr. Paul Joseph Briesh Jr., EMT - I
- Title
- EMS Director
- Phone
- (575) 278-2101
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NM
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20051222000143 | NM | Part B Supplier - Ambulance Service Supplier | 8921020645 | Practice locations: Des Moines, NM |
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Land Ambulance | 3416L0300X | Yes |
Addresses
Primary practice location
77 North Olive St
Des Moines, NM 88418
Mailing address
PO Box 127
Des Moines, NM 88418-0127
Phone (575) 278-2127
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 20699 | Other | NM | EMS/AMBULANCE STATE CERTIFICATION NUMBER |
Other names
- DES MOINES AMBULANCE SERVICE
Other providers in Des Moines, NM
All providers in Des Moines, NM · Land Ambulance in New Mexico
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 9, 2010. 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.