Provider Demographics
NPI:1861504540
Name:ALAMOGORDO MUNICIPAL SCHOOLS
Entity Type:Organization
Organization Name:ALAMOGORDO MUNICIPAL SCHOOLS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAID SPECIALIST
Authorized Official - Prefix:
Authorized Official - First Name:EDNA
Authorized Official - Middle Name:
Authorized Official - Last Name:GILL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:505-439-3200
Mailing Address - Street 1:PO BOX 650
Mailing Address - Street 2:
Mailing Address - City:ALAMOGORDO
Mailing Address - State:NM
Mailing Address - Zip Code:88311-0650
Mailing Address - Country:US
Mailing Address - Phone:505-439-3200
Mailing Address - Fax:505-434-1840
Practice Address - Street 1:1211 HAWAII AVE
Practice Address - Street 2:
Practice Address - City:ALAMOGORDO
Practice Address - State:NM
Practice Address - Zip Code:88310-6437
Practice Address - Country:US
Practice Address - Phone:505-439-3200
Practice Address - Fax:505-434-1840
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-31
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)
Provider Identifiers
StateIdentifier IDID TypeIssuer
NM76131Medicaid