Healthcare Provider Details

I. General information

NPI: 1801666482
Provider Name (Legal Business Name): AVASTAR TRANSPORTS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/04/2024
Last Update Date: 01/04/2024
Certification Date: 01/04/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1201 W CHANNEL ISLANDS BLVD
OXNARD CA
93033-4250
US

IV. Provider business mailing address

1201 W CHANNEL ISLANDS BLVD
OXNARD CA
93033-4250
US

V. Phone/Fax

Practice location:
  • Phone: 805-607-5220
  • Fax:
Mailing address:
  • Phone: 805-607-5220
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code347E00000X
TaxonomyTransportation Broker
License Number
License Number State

VIII. Authorized Official

Name: MARCEILE WILSON
Title or Position: CEO
Credential:
Phone: 805-607-5220