Organization
JJDAC, LLC
Active
Parent organization
JJDAC, LLC
Other names
Med Star Ambulance, Med Star Ambulance
Organization subpart
Yes
Provider details
NPI number
Legal business name
JJDAC, LLC
Authorized official
BRIAN SCOTT TIERNEY (EVP, CHIEF FINANCIAL OFFICER)
(833) 703-2294
Entity
Organization
Contact information
Practice address
208 W MALONEY AVE, GALLUP, NM 87301-5214
(505) 722-5295
(575) 523-0459
Mailing address
PO BOX 56141, LOS ANGELES, CA 90074-6141
(800) 913-9106
Taxonomy
Speciality
Code
Description
License number
State
341600000X
Ambulance
—
—
3416L0300X
Land Ambulance
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
15677567
—
NM
05
—
406293
—
AZ
05
—
9000164955
—
CO
Enumeration date
12/18/2017
Last updated
03/25/2026
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