Organization
VILLAGE OF RUIDOSO AMBULANCE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MARK REIFSTECK (SR VP CHIEF OPERATING OFFICER)
(505) 841-1392
Entity
Organization
Contact information
Practice address
211 SUDDERTH DR, RUIDOSO, NM 88345-6002
(505) 257-8297
(505) 257-3617
Mailing address
PO BOX 26666, PROVIDER ENROLLMENT, ALBUQUERQUE, NM 87125-6666
(505) 823-8528
(505) 823-8555
Taxonomy
Speciality
Code
Description
License number
State
3416L0300X
Land Ambulance
Primary
6052
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00224
—
NM
Enumeration date
12/13/2005
Last updated
08/22/2020
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