| Organization Name: | MANCOS AMBULANCE ASSOCIATION |
| NPI Number: | 1215141965 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | CATHY KENNEDY (ADMINISTRATIVE ASSISTANT) |
| Mailing Address: | 41595 Hyw 160 Mancos |
| State: | CO US |
| Postal Code: | 81328 |
| Phone Number: | 9705337400 |
| Fax Number: | 9705331425 |
| NPI Enumeration Date: | 05/10/2007 |
| NPI Last Update Date: | 10/22/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 3416L0300X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | CO |
| Taxonomy Type: | Transportation Services |
| Taxonomy Classification: | Ambulance |
| Taxonomy Specialization: | Land Transport |
| Taxonomy Definition: | |