Provider Demographics
NPI:1386768463
Name:PUEBLO OF ZUNI EMS
Entity type:Organization
Organization Name:PUEBLO OF ZUNI EMS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF
Authorized Official - Prefix:
Authorized Official - First Name:EDWARD
Authorized Official - Middle Name:A
Authorized Official - Last Name:SANCHEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:505-782-4833
Mailing Address - Street 1:#04 THIRD STREET
Mailing Address - Street 2:P.O. BOX 339
Mailing Address - City:ZUNI
Mailing Address - State:NM
Mailing Address - Zip Code:87327-0339
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:505-782-4591
Practice Address - Street 1:#04 THIRD STREET
Practice Address - Street 2:
Practice Address - City:ZUNI
Practice Address - State:NM
Practice Address - Zip Code:87327-0339
Practice Address - Country:US
Practice Address - Phone:505-782-4833
Practice Address - Fax:505-782-4591
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-16
Last Update Date:2008-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM144373416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
NM000R0593Medicaid
NM000R0593Medicaid
NM000R0593Medicaid