Village of Cloudcroft
Organization Active NPI Ambulance · Cloudcroft, NM
NPI 1891828554 · NPPES record last updated Aug 22, 2020
Key facts
- NPI
- 1891828554
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Ambulance 341600000X
- Legal business name
- VILLAGE OF CLOUDCROFT
- Practice address
- 1100 James Canyon Hwy
Cloudcroft, NM 88317-0317 - Phone
- (505) 682-3409
- Fax
- (505) 682-1102
- NPI assigned
- Mar 13, 2007
- Organization subpart
- No
Authorized official
- Name
- Mr. Steve Grulke
- Title
- EMS Director
- Phone
- (505) 682-2411
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NM
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20040928000046 | NM | Part B Supplier - Ambulance Service Supplier | 3678542610 | Practice locations: Cloudcroft, NM |
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Ambulance | 341600000X | Yes |
Addresses
Primary practice location
1100 James Canyon Hwy
Cloudcroft, NM 88317-0317
Mailing address
PO Box 317
Cloudcroft, NM 88317-0317
Phone (505) 682-2411
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| A2667 | Medicaid | NM |
Other names
- Cloudcroft Ambulance Service
Other providers in Cloudcroft, NM
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 22, 2020. 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.