Provider Demographics
NPI:1558589028
Name:VILLAGE OF FOLSOM NEW MEXICO
Entity Type:Organization
Organization Name:VILLAGE OF FOLSOM NEW MEXICO
Other - Org Name:FOLSOM EMS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MUNICIPAL CLERK
Authorized Official - Prefix:MRS
Authorized Official - First Name:DIANNE
Authorized Official - Middle Name:E
Authorized Official - Last Name:BROWN
Authorized Official - Suffix:
Authorized Official - Credentials:EMTB
Authorized Official - Phone:505-278-3657
Mailing Address - Street 1:PO BOX 370
Mailing Address - Street 2:
Mailing Address - City:FOLSOM
Mailing Address - State:NM
Mailing Address - Zip Code:88419-0370
Mailing Address - Country:US
Mailing Address - Phone:505-278-3657
Mailing Address - Fax:505-278-3658
Practice Address - Street 1:338 DODGE STREET
Practice Address - Street 2:
Practice Address - City:FOLSOM
Practice Address - State:NM
Practice Address - Zip Code:88419
Practice Address - Country:US
Practice Address - Phone:505-278-3657
Practice Address - Fax:505-278-3658
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-23
Last Update Date:2008-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM450073416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
NM01753358009OtherCRS