Provider Demographics
NPI:1053583948
Name:WEST ROAD EMERGENCY PHYSICIANS
Entity type:Organization
Organization Name:WEST ROAD EMERGENCY PHYSICIANS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE VICE PRESIDENT, EMCARE PH
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:L
Authorized Official - Last Name:MURPHY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:800-444-7009
Mailing Address - Street 1:P.O. BOX 98668
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89193
Mailing Address - Country:US
Mailing Address - Phone:800-444-7009
Mailing Address - Fax:800-305-3233
Practice Address - Street 1:117 EAST 19TH ST.
Practice Address - Street 2:
Practice Address - City:ROSWELL
Practice Address - State:NM
Practice Address - Zip Code:88201-5151
Practice Address - Country:US
Practice Address - Phone:575-627-7007
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-31
Last Update Date:2009-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NM33338779Medicaid
NMNM007E47OtherBLUE SHIELD
NM33338779Medicaid
NM33338779Medicaid
NMNM007E47OtherBLUE SHIELD