Healthcare Provider Details

I. General information

NPI: 1437116662
Provider Name (Legal Business Name): SIERRA VISTA HOSPITAL AMBULANCE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/01/2006
Last Update Date: 06/28/2021
Certification Date: 06/28/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

800 E 9TH AVE
TRUTH OR CONSEQUENCES NM
87901-1954
US

IV. Provider business mailing address

800 EAST NINTH STREET
TRUTH OR CONSEQUENCES NM
87901
US

V. Phone/Fax

Practice location:
  • Phone: 505-894-2111
  • Fax: 575-894-7659
Mailing address:
  • Phone: 505-894-2111
  • Fax: 505-894-7659

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code341600000X
TaxonomyAmbulance
License Number
License Number State

VIII. Authorized Official

Name: CHUN-MING HUANG
Title or Position: CFO
Credential:
Phone: 575-894-2111