Organization
COSTILLA COUNTY AMBULANCE DISTRICT
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. SHERRI MARIE VIGIL (OFFICE MANAGER)
(719) 580-2031
Entity
Organization
Contact information
Practice address
233 MAIN ST, BUILDING 2, SAN LUIS, CO 81152
(719) 672-4271
(270) 744-8642
Mailing address
PO BOX 9150, PADUCAH, KY 42002-9150
(719) 672-4271
(719) 672-4277
Taxonomy
Speciality
Code
Description
License number
State
3416L0300X
Land Ambulance
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
9000168483
—
CO
Enumeration date
01/17/2020
Last updated
03/15/2021
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