1033142443 NPI number — INCORPORATED COUNTY OF LOS ALAMOS

Table of content: (NPI 1033142443)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1033142443 NPI number — INCORPORATED COUNTY OF LOS ALAMOS

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
INCORPORATED COUNTY OF LOS ALAMOS
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
LOS ALAMOS COUNTY FIRE
Provider Other Organization Name Type Code:
3
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1033142443
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
01/18/2021
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
999 CENTRAL AVE STE 200
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
LOS ALAMOS
Provider Business Mailing Address State Name:
NM
Provider Business Mailing Address Postal Code:
87544-3328
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
505-662-8318
Provider Business Mailing Address Fax Number:
505-662-8302

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
999 CENTRAL AVE
Provider Second Line Business Practice Location Address:
SUITE 200
Provider Business Practice Location Address City Name:
LOS ALAMOS
Provider Business Practice Location Address State Name:
NM
Provider Business Practice Location Address Postal Code:
87544-3330
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
505-662-8318
Provider Business Practice Location Address Fax Number:
505-662-8302
Provider Enumeration Date:
07/09/2006

Additional Information

Authorized Official

Authorized Official Last Name:
BARTLETT
Authorized Official First Name:
CHRISTOPHER
Authorized Official Middle Name:
Authorized Official Title or Position:
EMS DIVISION CHIEF
Authorized Official Telephone Number:
505-709-5042

Provider Taxonomy Codes

  • Taxonomy code: 3416L0300X , with the licence number:  41036 , registered in the state of NM ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 201080137 . This is a "PRESBYTERIAN SALUD" identifier , issued by the state of ( NM ) . This identifiers is of the category "OTHER".
  • Identifier: 4074870 . This is a "BLUE CROSS/BLUE SHIELD" identifier . This identifiers is of the category "OTHER".
  • Identifier: G008A95 . This is a "MUTUAL OF OMAHA" identifier . This identifiers is of the category "OTHER".
  • Identifier: 00NM00R031 . This is a "BLUE CROSS/BLUE SHIELD" identifier . This identifiers is of the category "OTHER".
  • Identifier: 000R2247 , issued by the state of ( NM ) . This identifiers is of the category "MEDICAID".
  • Identifier: 3142 . This is a "KAISER PERMANENTE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 201080137 . This is a "PRESBYTERIAN INSURANCE C" identifier . This identifiers is of the category "OTHER".
  • Identifier: 13847 . This is a "PRESBYTERIAN HEALTH PLAN" identifier . This identifiers is of the category "OTHER".




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