Organization
PUEBLO OF JEMEZ
Active
Organization subpart
No
Provider details
NPI number
Authorized official
NOHEMY ROSALES (BUSINESS OFFICE MANAGER)
(575) 834-3187
Entity
Organization
Contact information
Practice address
4535 HIGHWAY 4, JEMEZ PUEBLO, NM 87024-0219
(575) 834-7359
Mailing address
4535 HIGHWAY 4, JEMEZ PUEBLO, NM 87024-0219
(575) 834-7359
Taxonomy
Speciality
Code
Description
License number
State
3416L0300X
Land Ambulance
Primary
124046
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
R3638
—
NM
Enumeration date
01/30/2007
Last updated
02/11/2022
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