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General NPI Number Information
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NPI Number | 1386630242
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Entity Type | Organization
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Legal Business Name | VILLAGE OF CAUSEY
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Dates
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Enumeration Date | 09/26/2005
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Last Update Date | 04/20/2008
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Provider Practice Location Address
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Address Line | 116 MAIN ST BOX 79
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City | CAUSEY
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State | NM
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Zip | 88113-9717
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Country | US
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Telephone | 505-273-4249
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Fax | 505-273-4248
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Provider Business Mailing Address
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Address Line | 116 MAIN ST BOX 79
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City | CAUSEY
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State | NM
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Zip | 88113-9717
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Country | US
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Telephone | 505-273-4249
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Fax | 505-273-4248
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Authorized Official
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Title or Position | EMS CAPTAIN
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Name | T. ANN CLARK
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Credential | EMT-I
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Telephone | 505-273-4249
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 146M00000X
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Taxonomy Name | Intermediate Emergency Medical Technician
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License Number | 0323312
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License Number State | NM
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