COSTILLA COUNTY AMBULANCE DISTRICT NPI 1699912592

NPI Information

NPI: 1699912592
Provider Name: COSTILLA COUNTY AMBULANCE DISTRICT
Classification: Ambulance - 3416L0300X
Entity Type: Organization

Specialization: Land Transport

CLIA Number: 06D1026424

Address:
233 MAIN ST.
SAN LUIS, CO
ZIP 81152
Phone: (719) 672-4271
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COSTILLA COUNTY AMBULANCE DISTRICT is a land transport ambulance in San Luis, CO. COSTILLA COUNTY AMBULANCE DISTRICT NPI is 1699912592. The provider is registered as an organization entity type.

The provider's business location address is:

233 MAIN ST.
SAN LUIS, CO
ZIP 81152-035
Phone: (719) 672-4271
Fax: (719) 672-4277

The provider's authorized official is Sherri Vigil .
The authorized official title is Assistant Director and has the following contact phone number (719) 580-2031.

The CLIA number assigned to this NPI record is 06D1026424 - ambulance with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 1/14/2009 and was last updated on 2/22/2021.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	3416L0300X	Ambulance	Land Transport			Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	40029077	MEDICAID	COLORADO

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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