Organization
TOWN OF ESTANCIA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LESTER E. GARY PARAMEDIC (FIRE CHIEF)
(505) 384-4338
Entity
Organization
Contact information
Practice address
1000 HIGHLAND AVE., ESTANCIA, NM 87016-9998
(505) 384-4338
(505) 384-5351
Mailing address
PO BOX 641880, OMAHA, NE 68164-7880
(402) 572-4019
Taxonomy
Speciality
Code
Description
License number
State
3416L0300X
Land Ambulance
Primary
NMPRC29222
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
05521009
—
NM
Enumeration date
04/09/2007
Last updated
02/10/2017
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