Healthcare Provider Details

I. General information

NPI: 1992588255
Provider Name (Legal Business Name): SCOOT TRANSPORT LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/18/2023
Last Update Date: 08/18/2023
Certification Date: 08/17/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

MESA FARM ROAD 1ST WASH
SHIPROCK NM
87420-2196
US

IV. Provider business mailing address

PO BOX 2196
SHIPROCK NM
87420-2196
US

V. Phone/Fax

Practice location:
  • Phone: 480-313-5339
  • Fax:
Mailing address:
  • Phone: 480-313-5339
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License Number
License Number State

VIII. Authorized Official

Name: BEATRICE REDFEATHER
Title or Position: OPERATIONS MANAGER
Credential:
Phone: 480-313-5339