Organization
VILLAGE OF LOGAN
Active
Other names
Logan Ambulance Service
Organization subpart
No
Provider details
NPI number
Authorized official
JUSTIN LEBLANC (EMS DIRECTOR)
(575) 403-6870
Entity
Organization
Contact information
Practice address
108A US HWY 54, LOGAN, NM 88426
(505) 487-2234
(505) 487-2400
Mailing address
PO BOX 7, LOGAN, NM 88426-0007
(505) 487-2234
(505) 487-2400
Taxonomy
Speciality
Code
Description
License number
State
341600000X
Ambulance
Primary
12549
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
39910
PRES SALUD, MEDICAID
NM
01
—
590005180
RAILROAD MEDICARE
NM
01
—
8182424
UNITED HEALTHCARE
NM
01
—
C253004
UNITED AMERICA
NM
01
—
R170
BCBS
NM
05
—
R2577
—
NM
Enumeration date
04/26/2007
Last updated
02/07/2025
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