Organization
JJDAC INC.
Active
Other names
Med Star Ambulance
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ERIC THOMAS (SVP OF REVENUE MANAGEMENT)
(877) 288-5340
Entity
Organization
Contact information
Practice address
511 NIZHONI BLVD, GALLUP, NM 87301
(505) 722-5295
(505) 722-6426
Mailing address
PO BOX 610, GALLUP, NM 87305-0511
(505) 722-5295
(505) 722-6426
Taxonomy
Speciality
Code
Description
License number
State
341600000X
Ambulance
Primary
51164
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
R3562
—
NM
Enumeration date
12/01/2006
Last updated
08/03/2018
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