MEDICARE: SANTA FE COUNTY

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	3416L0300X	Land Ambulance	42343	NM

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1316940026
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SANTA FE COUNTY

Provider Business Mailing Address
First Line	:	35 CAMINO JUSTICIA
Second Line	:
City	:	SANTA FE
State	:	NM
Zip	:	87508-8501
Country	:	US
Telephone Number	:	505-992-3071
Fax Number	:	505-992-3073

Provider Business Practice Location Address
First Line	:	35 CAMINO JUSTICIA
Second Line	:
City	:	SANTA FE
State	:	NM
Zip	:	87508-8501
Country	:	US
Telephone Number	:	505-992-3071
Fax Number	:	505-992-3073

Authorized Official
Title or Position	:	BILLING MANAGER
Name	:	MS. LORIE M. MULLINGS
Credential	:
Telephone Number	:	505-992-3071

Provider Enumeration Date	:	05/27/2005
Last Update Date	:	11/19/2009

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Directions to “SANTA FE COUNTY ” Practice Location

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