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General NPI Number Information
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NPI Number | 1043382427
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Entity Type | Organization
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Legal Business Name | CITY OF TUCUMCARI
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Dates
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Enumeration Date | 11/14/2006
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Last Update Date | 02/16/2012
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Provider Practice Location Address
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Address Line | 225 E CENTER ST
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City | TUCUMCARI
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State | NM
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Zip | 88401-2214
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Country | US
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Telephone | 505-461-2558
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Fax | 505-461-2561
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Provider Business Mailing Address
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Address Line | PO BOX 1188
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City | TUCUMCARI
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State | NM
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Zip | 88401-1188
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Country | US
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Telephone | 505-461-2558
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Fax | 505-461-2561
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Authorized Official
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Title or Position | EMS DIRECTOR
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Name | MS. BRENDA KAYE RIVALE
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Credential |
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Telephone | 575-461-2558
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3416L0300X
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Taxonomy Name | Land Ambulance
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License Number | 2754
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License Number State | NM
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