Provider Demographics
NPI:1720198153
Name:CITY OF CARLSBAD
Entity Type:Organization
Organization Name:CITY OF CARLSBAD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FIRE CHIEF
Authorized Official - Prefix:MR
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:
Authorized Official - Last Name:LOPEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:575-887-1191
Mailing Address - Street 1:PO BOX 1569
Mailing Address - Street 2:
Mailing Address - City:CARLSBAD
Mailing Address - State:NM
Mailing Address - Zip Code:88221-1569
Mailing Address - Country:US
Mailing Address - Phone:505-887-1191
Mailing Address - Fax:575-887-8566
Practice Address - Street 1:101 N HALAGUENO ST
Practice Address - Street 2:
Practice Address - City:CARLSBAD
Practice Address - State:NM
Practice Address - Zip Code:88220
Practice Address - Country:US
Practice Address - Phone:505-887-1191
Practice Address - Fax:575-887-8566
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-30
Last Update Date:2015-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
341600000X
NM3416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
No341600000XTransportation ServicesAmbulance
Provider Identifiers
StateIdentifier IDID TypeIssuer
NMR0803OtherSUPERIOR MEDICAL TRANS
NMR0803Medicaid
NM2504287Medicare PIN