Organization
VILLAGE OF FORT SUMNER
Active
Other names
FT SUMNER AMBULANCE
Organization subpart
No
Provider details
NPI number
Authorized official
BONNIE LILLY (ADMINISTRATOR)
(575) 355-2401
Entity
Organization
Contact information
Practice address
173 E AVE C, FT SUMNER, NM 88119
(575) 355-2401
Mailing address
PO BOX 180, FORT SUMNER, NM 88119-0180
(575) 355-2401
Taxonomy
Speciality
Code
Description
License number
State
341600000X
Ambulance
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
R4656
—
NM
Enumeration date
03/05/2007
Last updated
11/07/2013
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