Organization
JICARILLA EMS
Active
Parent organization
JUCARILLA EMS
Organization subpart
Yes
Provider details
NPI number
Legal business name
JUCARILLA EMS
Authorized official
MRS. DAWN BURNS (ACTING DIRECTOR)
(575) 759-3778
Entity
Organization
Contact information
Practice address
2300 NARROW GAUGE RD, DULCE, NM 87528
(575) 759-3778
(575) 759-3841
Mailing address
POB 769, 2300 NARROW GAUGE RD, DULCE, NM 87528
(575) 759-3778
(575) 759-3841
Taxonomy
Speciality
Code
Description
License number
State
3416L0300X
Land Ambulance
Primary
47495
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
R134
BLUE CROSS BLUE SHIELD
NM
05
—
R2939
—
NM
Enumeration date
03/08/2007
Last updated
02/21/2013
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