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General NPI Number Information
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NPI Number | 1891910295
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Entity Type | Organization
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Legal Business Name | PECOS VALLEY AMBULANCE SERVICE
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Dates
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Enumeration Date | 04/13/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 521 HWY 50
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City | PECOS
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State | NM
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Zip | 87552-0710
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Country | US
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Telephone | 505-757-6482
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Fax | 505-757-2700
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Provider Business Mailing Address
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Address Line | PO BOX 710 HWY 50
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City | PECOS
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State | NM
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Zip | 87552-0710
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Country | US
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Telephone | 505-757-6482
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Fax | 505-757-2700
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | SIGRID OLSON
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Credential |
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Telephone | 505-757-6482
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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 | NM
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