Healthcare Provider Details

I. General information

NPI: 1265207179
Provider Name (Legal Business Name): CEDAR TRANSIT
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/20/2023
Last Update Date: 11/20/2023
Certification Date: 11/20/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

201 HIGHWAY N11-49 UNIT A
CHURCH ROCK NM
87311-8913
US

IV. Provider business mailing address

PO BOX 1463
CHURCH ROCK NM
87311-1463
US

V. Phone/Fax

Practice location:
  • Phone: 505-488-3919
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code344600000X
TaxonomyTaxi
License Number
License Number State

VIII. Authorized Official

Name: MARIA REYES
Title or Position: FOUNDER
Credential:
Phone: 505-488-3919