Organization
VILLAGE OF CAUSEY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
T. ANN CLARK EMT-I (EMS CAPTAIN)
(505) 273-4249
Entity
Organization
Contact information
Practice address
116 MAIN ST, BOX 79, CAUSEY, NM 88113-9717
(505) 273-4249
(505) 273-4248
Mailing address
116 MAIN ST, BOX 79, CAUSEY, NM 88113-9717
(505) 273-4249
(505) 273-4248
Taxonomy
Speciality
Code
Description
License number
State
146M00000X
Intermediate Emergency Medical Technician
Primary
0323312
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
R2916
—
NM
Enumeration date
09/26/2005
Last updated
04/20/2008
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