Organization
TOWN OF HAGERMAN
Active
Parent organization
TOWN OF HAGERMAN
Other names
Hagerman Ambulance Service
Organization subpart
Yes
Provider details
NPI number
Legal business name
TOWN OF HAGERMAN
Authorized official
CASSIUS G MASON III DPS DIRECTOR - EMT-I (DPS DIRECTOR)
(505) 752-3204
Entity
Organization
Contact information
Practice address
209 E ARGYLE, HAGERMAN, NM 88232
(575) 752-3204
(575) 752-5400
Mailing address
PO BOX 247, 209 E ARGYLE, HAGERMAN, NM 88232
(575) 752-3204
(575) 752-5400
Taxonomy
Speciality
Code
Description
License number
State
3416L0300X
Land Ambulance
Primary
24088
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2507679
MEDICARE PROVIDER NUMBER
NM
Enumeration date
04/09/2007
Last updated
07/14/2008
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