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General NPI Number Information
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NPI Number | 1588163703
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Entity Type | Organization
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Legal Business Name | FAMILY FAITH MEDICAL TRANSPORT LLC
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Dates
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Enumeration Date | 02/02/2018
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Last Update Date | 01/05/2026
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Provider Practice Location Address
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Address Line | 1710 MESQUITE DR
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City | GALLUP
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State | NM
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Zip | 87301-5741
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Country | US
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Telephone | 505-879-6971
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Fax | 505-488-2495
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Provider Business Mailing Address
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Address Line | 1710 MESQUITE DR
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City | GALLUP
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State | NM
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Zip | 87301-5741
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Country | US
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Telephone | 505-879-6971
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Fax | 505-488-2495
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Authorized Official
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Title or Position | OWNER/CEO
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Name | LAKERRA L KEE
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Credential |
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Telephone | 505-879-6971
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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 | AR
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