Organization
EXPRESS TRANSPORTATION OF NEW MEXICO, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DAVE DEVEREAUX (CO-OWNER)
(505) 881-7433
Entity
Organization
Contact information
Practice address
2123 MENAUL BLVD NE, SUITE B, ALBUQUERQUE, NM 87107-1745
(505) 881-7433
(505) 888-8877
Mailing address
2123 MENAUL BLVD NE, SUITE B, ALBUQUERQUE, NM 87107-1745
(505) 881-7433
(505) 888-8877
Taxonomy
Speciality
Code
Description
License number
State
343900000X
Non-emergency Medical Transport (VAN)
Primary
79172385
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
79172385
—
NM
Enumeration date
09/07/2010
Last updated
09/07/2010
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