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MED STAR AMBULANCE
NPI 1093883787
Ambulance in Gallup, NM

Active since December 01, 2006CLIA 32D2157149 · Waiver
511 NIZHONI BLVD, GALLUP, NM 87301(505) 722-5295(505) 722-6426 Get Directions Write a Review

NPPES record last updated: August 3, 2018. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Aug 3, 2018, Jun 21, 2018, Jul 21, 2017 (3 updates tracked since 2017).

About Med Star Ambulance NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MED STAR AMBULANCE (NPI 1093883787) is a healthcare organization registered as an ambulance in Gallup, New Mexico and active in the NPI registry since December 2006. The organization holds a CLIA Waiver certificate valid through October 30, 2026 and lists Eric Thomas, Svp Of Revenue Management, as its authorized official.

NPPES Registry Identity

NPI1093883787
Entity TypeOrganization
Primary Taxonomy341600000X
Legal Business NameJJDAC INC.
Location Address511 NIZHONI BLVDGallup, NM 87301
Mailing AddressPo Box 610Gallup, NM 87305-0511 · (505) 722-5295 · Fax (505) 722-6426
Phone(505) 722-5295
Fax(505) 722-6426
Organization SubpartNo
Authorized OfficialEric ThomasSvp Of Revenue Management · (877) 288-5340
Enumeration DateDecember 1, 2006
Last NPPES UpdateAugust 3, 20183 updates tracked since enumeration
✔ NPI 1093883787 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyAmbulanceTransportation Services
Taxonomy Code341600000X
License✔ Licensed in NM · 51164
Definition
An emergency vehicle used for transporting patients to a health care facility after injury or illness. Types of ambulances used in the United States include ground (surface) ambulance, rotor-wing (helicopter), and fixed-wing aircraft (airplane).
511 NIZHONI BLVD, Gallup, NM 87301
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Other Names 1

Doing Business AsMed Star Ambulance

Other Identifiers 1

MedicaidR3562NM

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 32D2157149

Jjdac LLC Dba Med Star Ambulance · Gallup, NM
Active · expires Oct 30, 2026
CLIA Number32D2157149
Laboratory TypeAmbulance
Certificate Effective DateOctober 31, 2024
Certificate Expiration DateOctober 30, 2026
Laboratory DirectorDannette Leggitt
Laboratory Phone(505) 722-5295
Laboratory LocationJjdac LLC Dba Med Star Ambulance208 W Maloney Ave, Gallup, NM 87301
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Jjdac Inc.'s NPI number?

The NPI number for Jjdac Inc. is 1093883787. It was assigned to this organization in the NPPES registry on December 1, 2006. The provider is doing business as Med Star Ambulance.

Where is Jjdac Inc. located?

Jjdac Inc. is located at 511 Nizhoni Blvd, Gallup, NM 87301. The listed phone number is (505) 722-5295.

What is Jjdac Inc.'s specialty?

The primary specialty registered for this NPI is Ambulance with taxonomy code 341600000X.

Does Jjdac Inc. hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 32D2157149) is associated with this NPI, valid through October 30, 2026. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Jjdac Inc. was last updated on August 3, 2018. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 8 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.