Provider Demographics
NPI:1053994194
Name:CITY OF GALLUP
Entity type:Organization
Organization Name:CITY OF GALLUP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EMS COORDINATOR
Authorized Official - Prefix:
Authorized Official - First Name:JESSICA
Authorized Official - Middle Name:
Authorized Official - Last Name:CREECH
Authorized Official - Suffix:
Authorized Official - Credentials:EMT-I/FF1
Authorized Official - Phone:505-863-1383
Mailing Address - Street 1:PO BOX 18230
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15236-0230
Mailing Address - Country:US
Mailing Address - Phone:505-863-1383
Mailing Address - Fax:
Practice Address - Street 1:1800 S SECOND ST
Practice Address - Street 2:
Practice Address - City:GALLUP
Practice Address - State:NM
Practice Address - Zip Code:87301-5838
Practice Address - Country:US
Practice Address - Phone:505-722-4195
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-05-05
Last Update Date:2021-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport