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General NPI Number Information
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NPI Number | 1508182007
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Entity Type | Organization
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Legal Business Name | VILLAGE OF DES MOINES
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Dates
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Enumeration Date | 04/09/2010
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Last Update Date | 04/09/2010
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Provider Practice Location Address
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Address Line | 77 NORTH OLIVE ST
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City | DES MOINES
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State | NM
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Zip | 88418
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Country | US
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Telephone | 575-278-3911
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Fax | 575-278-2106
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Provider Business Mailing Address
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Address Line | PO BOX 127
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City | DES MOINES
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State | NM
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Zip | 88418-0127
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Country | US
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Telephone | 575-278-2127
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Fax | 575-278-2126
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Authorized Official
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Title or Position | EMS DIRECTOR
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Name | MR. PAUL JOSEPH BRIESH JR.
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Credential | EMT - I
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Telephone | 575-278-2101
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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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