Healthcare Provider Details

I. General information

NPI: 1790763522
Provider Name (Legal Business Name): CITY OF CLOVIS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/03/2006
Last Update Date: 05/14/2026
Certification Date: 05/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

320 MITCHELL ST
CLOVIS NM
88101-7471
US

IV. Provider business mailing address

320 MITCHELL ST
CLOVIS NM
88101-7471
US

V. Phone/Fax

Practice location:
  • Phone: 575-763-9228
  • Fax:
Mailing address:
  • Phone: 575-763-9228
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code3416L0300X
TaxonomyLand Ambulance
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code341600000X
TaxonomyAmbulance
License NumberPRC12897
License Number StateNM

VIII. Authorized Official

Name: JACKIE PICCILLO
Title or Position: BILLING SPECIALIST
Credential: BILLING SPECIALIST
Phone: 575-763-9228