Provider Demographics
NPI:1780465393
Name:CITY OF SUNLAND PARK
Entity type:Organization
Organization Name:CITY OF SUNLAND PARK
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FIRE CHEIF
Authorized Official - Prefix:
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:
Authorized Official - Last Name:MEDRANO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:575-268-6224
Mailing Address - Street 1:1000 MCNUTT RD STE E
Mailing Address - Street 2:
Mailing Address - City:SUNLAND PARK
Mailing Address - State:NM
Mailing Address - Zip Code:88063-9200
Mailing Address - Country:US
Mailing Address - Phone:575-268-6224
Mailing Address - Fax:
Practice Address - Street 1:1000 MCNUTT RD STE E
Practice Address - Street 2:
Practice Address - City:SUNLAND PARK
Practice Address - State:NM
Practice Address - Zip Code:88063-9200
Practice Address - Country:US
Practice Address - Phone:575-268-6224
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-10-10
Last Update Date:2023-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207PE0004XAllopathic & Osteopathic PhysiciansEmergency MedicineEmergency Medical ServicesGroup - Multi-Specialty