Provider Demographics
NPI:1891847646
Name:HABIGER, THOMAS J (EMT-I)
Entity Type:Individual
Prefix:
First Name:THOMAS
Middle Name:J
Last Name:HABIGER
Suffix:
Gender:M
Credentials:EMT-I
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1921
Mailing Address - Street 2:
Mailing Address - City:GRANTS
Mailing Address - State:NM
Mailing Address - Zip Code:87020-1921
Mailing Address - Country:US
Mailing Address - Phone:505-287-2289
Mailing Address - Fax:505-287-5160
Practice Address - Street 1:1213 PEEL ST
Practice Address - Street 2:
Practice Address - City:GRANTS
Practice Address - State:NM
Practice Address - Zip Code:87020-3511
Practice Address - Country:US
Practice Address - Phone:505-287-8708
Practice Address - Fax:505-287-5160
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM00023539146M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes146M00000XEmergency Medical Service ProvidersEmergency Medical Technician, Intermediate