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General NPI Number Information
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NPI Number | 1477183408
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Entity Type | Organization
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Legal Business Name | CONEJOS COUNTY GOVERNMENT
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Dates
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Enumeration Date | 01/17/2020
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Last Update Date | 01/23/2020
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Provider Practice Location Address
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Address Line | 17705 STATE HWY 285 SUITE B
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City | LA JARA
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State | CO
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Zip | 81140
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Country | US
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Telephone | 719-274-5804
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Fax | 270-744-8642
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Provider Business Mailing Address
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Address Line | PO BOX 215
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City | CONEJOS
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State | CO
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Zip | 81129-0215
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Country | US
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Telephone | 719-274-5804
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Fax | 270-744-8642
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Authorized Official
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Title or Position | DIRECTOR
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Name | ERNEST D ABEYTA
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Credential |
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Telephone | 719-274-5084
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 341600000X
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Taxonomy Name | Ambulance
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License Number |
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License Number State |
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