Healthcare Provider Details

I. General information

NPI: 1750534418
Provider Name (Legal Business Name): ALTERNATIVE TRANSPORTATION LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/28/2008
Last Update Date: 10/28/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1215 ANTHONY DR SUITE A
ANTHONY NM
88021-2434
US

IV. Provider business mailing address

PO BOX 2434 1215 ANTHONY DR, SUITE A
ANTHONY NM
88021-2434
US

V. Phone/Fax

Practice location:
  • Phone: 575-882-5500
  • Fax: 575-882-5502
Mailing address:
  • Phone: 575-882-5500
  • Fax: 575-882-5502

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QH0100X
TaxonomyHealth Service Clinic/Center
License Number02945315001
License Number StateNM

VIII. Authorized Official

Name: MS. LUCY AGUILAR
Title or Position: DIRECTOR
Credential:
Phone: 575-882-5500