Healthcare Provider Details

I. General information

NPI: 1275462293
Provider Name (Legal Business Name): CITY OF ROSWELL OFFICE OF CLERK
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/15/2026
Last Update Date: 05/15/2026
Certification Date: 05/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 S RICHARDSON AVE
ROSWELL NM
88203-5730
US

IV. Provider business mailing address

PO BOX 1869
ROSWELL NM
88202-1869
US

V. Phone/Fax

Practice location:
  • Phone: 575-624-6800
  • Fax:
Mailing address:
  • Phone: 575-624-6800
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: RANDY BUNCH
Title or Position: EMS CHIEF
Credential:
Phone: 575-624-6800