Healthcare Provider Details

I. General information

NPI: 1063339828
Provider Name (Legal Business Name): LA SELLEPEAK RX DELIVERY AND TRANSPORTATION LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/02/2026
Last Update Date: 07/02/2026
Certification Date: 07/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

318 PASEO DEL PUEBLO NORTE UNIT 861
TAOS NM
87571-9036
US

IV. Provider business mailing address

PO BOX 861
TAOS NM
87571-0861
US

V. Phone/Fax

Practice location:
  • Phone: 718-679-4560
  • Fax:
Mailing address:
  • Phone: 718-679-4560
  • 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: HOWARD E GALLA
Title or Position: MANAGING MEMBER
Credential:
Phone: 718-679-4560