Organization
MINERAL COUNTY
Active
Other names
Mineral County Ambulance
Organization subpart
No
Provider details
NPI number
Authorized official
ERICA RODEN (BILLING DIRECTOR)
(817) 776-1017
Entity
Organization
Contact information
Practice address
800 RIO GRANDE AVE, CREEDE, CO 81130-5000
(719) 223-9033
(719) 223-9033
Mailing address
PO BOX 381, CREEDE, CO 81130-0224
(719) 223-9033
(719) 223-9033
Taxonomy
Speciality
Code
Description
License number
State
341600000X
Ambulance
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
36580872
—
CO
01
—
590015075
RAILROAD MEDICARE
CO
Enumeration date
08/19/2006
Last updated
06/13/2022
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