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General NPI Number Information
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NPI Number | 1265928790
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Entity Type | Organization
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Legal Business Name | BLUE SKY LOGISTICS INC
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Dates
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Enumeration Date | 07/09/2018
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Last Update Date | 07/09/2018
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Provider Practice Location Address
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Address Line | 1605 N GARDEN AVE
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City | ROSWELL
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State | NM
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Zip | 88201-7534
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Country | US
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Telephone | 575-208-0676
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Fax | 575-625-1973
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Provider Business Mailing Address
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Address Line | PO BOX 99
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City | ROSWELL
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State | NM
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Zip | 88202-0099
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Country | US
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Telephone | 575-208-0676
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Fax | 575-625-1973
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. CAMRON LEE ADAMS
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Credential |
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Telephone | 575-208-2725
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 344600000X
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Taxonomy Name | Taxi
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License Number | 54998
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License Number State | NM
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Taxonomy #2
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Taxonomy Code | 343900000X
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Taxonomy Name | Non-emergency Medical Transport (VAN)
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License Number | 55850
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License Number State | NM
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