| Organization Name: | JICARILLA EMS |
| NPI Number: | 1477684447 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | DAWN BURNS (ACTING DIRECTOR) |
| Mailing Address: | 2300 Narrow Gauge Rd Dulce |
| State: | NM US |
| Postal Code: | 87528 |
| Phone Number: | 5757593778 |
| Fax Number: | 5757593841 |
| NPI Enumeration Date: | 03/08/2007 |
| NPI Last Update Date: | 02/21/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 3416L0300X |
| License Number: | 47495 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NM |
| Taxonomy Type: | Transportation Services |
| Taxonomy Classification: | Ambulance |
| Taxonomy Specialization: | Land Transport |
| Taxonomy Definition: | |