1861412777 NPI number — ALAMO NAVAJO SCHOOL BOARD, INC.

Table of content: (NPI 1861412777)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1861412777 NPI number — ALAMO NAVAJO SCHOOL BOARD, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ALAMO NAVAJO SCHOOL BOARD, INC.
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:
Provider Other Organization Name Type Code:
6
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:
1861412777
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
03/07/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 5907
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
ALAMO
Provider Business Mailing Address State Name:
NM
Provider Business Mailing Address Postal Code:
87825
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
575-854-2626
Provider Business Mailing Address Fax Number:
575-854-2528

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
MILEPOST 29, HIGHWAY 169
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
ALAMO
Provider Business Practice Location Address State Name:
NM
Provider Business Practice Location Address Postal Code:
87825
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
575-854-2626
Provider Business Practice Location Address Fax Number:
575-854-2528
Provider Enumeration Date:
07/20/2006

Additional Information

Authorized Official

Authorized Official Last Name:
COLLINS
Authorized Official First Name:
CLORA
Authorized Official Middle Name:
PHYLLIS
Authorized Official Title or Position:
HEALTH SERVICES DIRE
Authorized Official Telephone Number:
575-854-2626

Provider Taxonomy Codes

  • Taxonomy code: 261QP2300X , with the licence number:  J6136 , 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: J6136 , issued by the state of ( NM ) . This identifiers is of the category "MEDICAID".
  • Identifier: B5467 . This is a "NM DRUG NUMBER" identifier , issued by the state of ( NM ) . This identifiers is of the category "OTHER".
  • Identifier: 3210298 . This is a "NABP NUMBER" identifier , issued by the state of ( NM ) . This identifiers is of the category "OTHER".




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