Organization
PUERCO VALLEY AMBULANCE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TAMI WOOD (ASSISTANT ADMIN CHIEF)
(928) 688-3616
Entity
Organization
Contact information
Practice address
105 S HWY 191, SANDERS, AZ 86512
(928) 688-3616
(928) 688-2922
Mailing address
PO BOX 39, SANDERS, AZ 86512-0039
(928) 688-3616
(928) 688-2922
Taxonomy
Speciality
Code
Description
License number
State
3416L0300X
Land Ambulance
Primary
116
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
070558
—
AZ
05
—
R3451
—
NM
Enumeration date
02/01/2006
Last updated
06/18/2024
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