Organization
SOUTHWEST AMBULANCE OF NEW MEXICO
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. BRYAN GIBSON (GROUP PRESIDENT)
(480) 655-7202
Entity
Organization
Contact information
Practice address
108 WEST DENNING, ROSWELL, NM 88203
(480) 627-6420
(480) 627-6243
Mailing address
PO BOX 26896, ALBUQUERQUE, NM 87125-6896
(480) 627-6143
(480) 627-6243
Taxonomy
Speciality
Code
Description
License number
State
341600000X
Ambulance
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
03430251
—
NM
01
—
NM00RC35
BCBS PIN
NM
Enumeration date
05/30/2006
Last updated
12/21/2009
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