Provider Demographics
NPI:1457493934
Name:CITY OF EUNICE
Entity Type:Organization
Organization Name:CITY OF EUNICE
Other - Org Name:EUNICE FIRE & RESCUE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:EMS DIVISION CHIEF
Authorized Official - Prefix:MR
Authorized Official - First Name:JESSE
Authorized Official - Middle Name:N
Authorized Official - Last Name:DAVIS
Authorized Official - Suffix:
Authorized Official - Credentials:NRP
Authorized Official - Phone:575-394-3258
Mailing Address - Street 1:PO BOX 747
Mailing Address - Street 2:
Mailing Address - City:EUNICE
Mailing Address - State:NM
Mailing Address - Zip Code:88231-0747
Mailing Address - Country:US
Mailing Address - Phone:575-394-3258
Mailing Address - Fax:575-394-3495
Practice Address - Street 1:1107 AVENUE J
Practice Address - Street 2:
Practice Address - City:EUNICE
Practice Address - State:NM
Practice Address - Zip Code:88231
Practice Address - Country:US
Practice Address - Phone:575-394-3258
Practice Address - Fax:575-394-3495
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-13
Last Update Date:2014-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM124933416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
NM2501785Medicare ID - Type UnspecifiedAMBULANCE SERVICE