Provider Demographics
NPI:1417291295
Name:MORA COUNTY
Entity Type:Organization
Organization Name:MORA COUNTY
Other - Org Name:MORA COUNTY AMBULANCE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MORA COUNTY MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:
Authorized Official - Last Name:SANCHEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:575-387-5279
Mailing Address - Street 1:PO BOX 580
Mailing Address - Street 2:
Mailing Address - City:MORA
Mailing Address - State:NM
Mailing Address - Zip Code:87732-0580
Mailing Address - Country:US
Mailing Address - Phone:575-387-5279
Mailing Address - Fax:575-387-9022
Practice Address - Street 1:STATE HWY 518 MM 29.5
Practice Address - Street 2:#1 COURT HOUSE ROAD
Practice Address - City:MORA
Practice Address - State:NM
Practice Address - Zip Code:87732-0580
Practice Address - Country:US
Practice Address - Phone:575-387-5279
Practice Address - Fax:575-387-9022
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-11-19
Last Update Date:2012-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance