Provider Demographics
NPI:1568613768
Name:AMISTAD-HAYDEN AMBULANCE SERVICE
Entity Type:Organization
Organization Name:AMISTAD-HAYDEN AMBULANCE SERVICE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COORDINATOR
Authorized Official - Prefix:
Authorized Official - First Name:HELEN
Authorized Official - Middle Name:
Authorized Official - Last Name:THOMPKINS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:575-633-2858
Mailing Address - Street 1:771 TOMPKINS RD
Mailing Address - Street 2:
Mailing Address - City:AMISTAD
Mailing Address - State:NM
Mailing Address - Zip Code:88410-6225
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:771 TOMPKINS RD
Practice Address - Street 2:
Practice Address - City:AMISTAD
Practice Address - State:NM
Practice Address - Zip Code:88410-6225
Practice Address - Country:US
Practice Address - Phone:575-633-2858
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-10-06
Last Update Date:2008-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM1147578261QE0002X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QE0002XAmbulatory Health Care FacilitiesClinic/CenterEmergency Care