Healthcare Provider Details

I. General information

NPI: 1225265242
Provider Name (Legal Business Name): VILLAGE OF FLOYD
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/17/2009
Last Update Date: 10/27/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1572 NEW MEXICO 267
FLOYD NM
88118-0069
US

IV. Provider business mailing address

1572 NEW MEXICO 267 PO BOX 69
FLOYD NM
88118-0069
US

V. Phone/Fax

Practice location:
  • Phone: 575-478-2585
  • Fax: 575-478-2585
Mailing address:
  • Phone: 575-478-2585
  • Fax: 575-478-2585

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3416L0300X
TaxonomyLand Ambulance
License Number
License Number StateNM

VIII. Authorized Official

Name: TONI M WHITECOTTON
Title or Position: VILLAGE CLERK
Credential:
Phone: 575-478-2585