Organization
SIMPLE TRANSPORT
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BEATRICE REDFETHER (OWNER)
(505) 368-3911
Entity
Organization
Contact information
Practice address
MESA FARM ROAD 1ST WASH, SHIPROCK, NM 87420-2196
(505) 368-3911
(505) 368-3914
Mailing address
PO BOX 2196, SHIPROCK, NM 87420-2196
(505) 368-3911
(505) 368-3914
Taxonomy
Speciality
Code
Description
License number
State
343900000X
Non-emergency Medical Transport (VAN)
D00249013
AZ
347C00000X
Private Vehicle
Primary
D00249013
AZ
Other
Enumeration date
01/03/2013
Last updated
01/03/2013
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