Organization
COUNTY OF MOFFITT
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TOM SUSS (COORDINATOR)
(970) 826-3131
Entity
Organization
Contact information
Practice address
114 COLLUM ST, MAYBELL, CO 81640
(970) 826-3131
Mailing address
PO BOX 84, MAYBELL, CO 81640-0084
(970) 826-3131
Taxonomy
Speciality
Code
Description
License number
State
341600000X
Ambulance
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
29800838
—
CO
Enumeration date
08/22/2006
Last updated
08/22/2020
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