Healthcare Provider Details

I. General information

NPI: 1659079325
Provider Name (Legal Business Name): DJS TRANSPROTATION LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/21/2023
Last Update Date: 04/08/2025
Certification Date: 04/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1617 27TH ST # 15
LUBBOCK TX
79411-2451
US

IV. Provider business mailing address

40 W DICKENS RD
LOVINGTON NM
88260-8715
US

V. Phone/Fax

Practice location:
  • Phone: 575-408-9827
  • Fax:
Mailing address:
  • Phone: 575-408-9827
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code344600000X
TaxonomyTaxi
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code347C00000X
TaxonomyPrivate Vehicle
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License Number
License Number State

VIII. Authorized Official

Name: MR. JAYSON CLARK
Title or Position: CHIEF EXECUTIVE OFFICER
Credential:
Phone: 575-659-4874