Organization Name: | COSTILLA COUNTY AMBULANCE DISTRICT |
NPI Number: | 1699912592 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | RODNEY K KING (ADMINISTRATOR) |
Mailing Address: | 233 Main St. San Luis |
State: | CO US |
Postal Code: | 811520035 |
Phone Number: | 7196724271 |
Fax Number: | 7196724277 |
NPI Enumeration Date: | 01/14/2009 |
NPI Last Update Date: | 07/13/2010 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 3416L0300X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Transportation Services |
Taxonomy Classification: | Ambulance |
Taxonomy Specialization: | Land Transport |
Taxonomy Definition: |