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General NPI Number Information
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NPI Number | 1063227494
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Entity Type | Organization
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Legal Business Name | GUADALUPE COUNTY
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Dates
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Enumeration Date | 02/12/2025
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Last Update Date | 02/19/2025
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Provider Practice Location Address
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Address Line | 141 S 5TH ST
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City | SANTA ROSA
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State | NM
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Zip | 88435
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Country | US
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Telephone | 575-472-1013
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Fax |
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Provider Business Mailing Address
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Address Line | 117 CAMINO DE VIDA STE 100
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City | SANTA ROSA
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State | NM
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Zip | 88435-2267
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Country | US
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Telephone | 575-472-1013
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Fax | 575-541-3649
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Authorized Official
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Title or Position | REVENUE CYCLE/HIM DIRECTOR
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Name | LESLIE SANCHEZ
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Credential |
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Telephone | 575-472-1013
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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 |
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License Number State |
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