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General NPI Number Information
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NPI Number | 1285507343
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Entity Type | Organization
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Legal Business Name | AMISTAD TRANSPORTATION SERVICE LLC
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Dates
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Enumeration Date | 09/25/2025
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Last Update Date | 09/25/2025
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Provider Practice Location Address
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Address Line | 404 MAIN STREET
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City | LA JARA
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State | CO
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Zip | 81140
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Country | US
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Telephone | 214-334-2510
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 674
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City | SAN LUIS
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State | CO
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Zip | 81152-0674
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Country | US
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Telephone | 214-334-2510
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | JAMES BEAU MCQUAGGE
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Credential |
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Telephone | 214-334-2510
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 343900000X
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Taxonomy Name | Non-emergency Medical Transport (VAN)
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License Number |
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License Number State |
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