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Contact Information

VILLAGE OF LOGAN
108A US HWY 54
LOGAN, NM88426
 Phone: 505-487-2234
 Fax: 505-487-2400
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Ambulance

341600000X 59 Ambulance Service Provider
Indicates primary specialty

NPI Profile & details for VILLAGE OF LOGAN

NPI Number 1639399058
LBN Legal business name VILLAGE OF LOGAN
Authorized official JUSTIN LEBLANC - (EMS DIRECTOR)
Entity Organization
Organization subpart 1 No
Enumeration date 04/26/2007
Last updated 02/07/2025 - More than a year ago
Identifiers
NM License # 12549
NM Medicaid R2577
NM Other R170 BCBS
NM Other 39910 PRES SALUD, MEDICAID
NM Other 590005180 RAILROAD MEDICARE
NM Other C253004 UNITED AMERICA
NM Other 8182424 UNITED HEALTHCARE
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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