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Contact Information

JJDAC INC.
511 NIZHONI BLVD
GALLUP, NM87301
 Phone: 505-722-5295
 Fax: 505-722-6426
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Ambulance

341600000X 59 Ambulance Service Provider
Indicates primary specialty

NPI Profile & details for JJDAC INC.

NPI # 1093883787
LBN Legal business name JJDAC INC.
Authorized official ERIC THOMAS - (SVP OF REVENUE MANAGEMENT)
Entity Organization
Organization subpart 1 No
Enumeration date 12/01/2006
Last updated 08/03/2018 - About 8 years ago
Identifiers
NM License # 51164
NM Medicaid R3562
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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