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Costilla County Ambulance District

Costilla County Ambulance District is a health care provider in San Luis, CO. In this page you will find its mailing address, practice location, phone number, specialty etc.

physician-icon Basic Information

Practice Location 233 Main St., San Luis, CO 81152-0035, US
Practice Location Phone719-672-4271
Practice Location Fax719-672-4277
Legal Business NameCOSTILLA COUNTY AMBULANCE DISTRICT
NPI ?1699912592
Entity TypeOrganization
Enumeration Date ? Jan 14, 2009
Last Update Date ? Jul 13, 2010
Note:
NPI: National Provider Identifier issued to health care providers by Centers for Medicare and Medicaid Services (CMS).

specialty-icon Specialties & Licenses of Costilla County Ambulance District

SpecialtySpecializationLicenseLicense State
AmbulanceLand Transport

legacy-id-icon Legacy Provider IDs of Costilla County Ambulance District

Provider IdIssuer StateIssuer TypeIssuer
40029077ColoradoMedicaid

official-icon Authorized Official of Costilla County Ambulance District

An authorized official is an appointed official with the legal authority to make changes and/or updates to the Costilla County Ambulance District's status and to commit the provider to fully abide by the laws and regulations relating to the National Provider Identifier (NPI).

Authorized Official Mr. Rodney K King
Authorized Official Title/PositionADMINISTRATOR
Authorized Official Phone Number719-588-5001