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Organization

SHUTTLE RUIDOSO, LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. DAVID R CASON II (PRESIDENT/CEO)
(575) 973-4079
Entity
Organization

Contact information

Practice address
1096 MECHEM DR, STE 312, RUIDOSO, NM 88345
(575) 257-1815
(575) 257-1816
Mailing address
1096 MECHEM DR, STE 312, RUIDOSO, NM 88345
(575) 257-1815
(575) 257-1816

Taxonomy

Speciality
Code
Description
License number
State
343900000X
Non-emergency Medical Transport (VAN)
Primary
NMPRC 54678
NM

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
57550328
NM
Enumeration date
06/10/2013
Last updated
06/25/2024
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