Organization
SAN JUAN SENTRY, LLC
Active
Organization
SAN JUAN SENTRY, LLC
Active
Other names
CORTEZ CAB
Organization subpart
No
Provider details
NPI number
Authorized official
EDWARD E GILBERT (MANAGING MEMBER)
(970) 560-4633
Entity
Organization
Contact information
Practice address
108 S CHESTNUT ST, CORTEZ, CO 81321-3532
(970) 565-6911
(970) 565-4480
Mailing address
PO BOX 669, CORTEZ, CO 81321-4240
(970) 565-6911
(970) 565-4480
Taxonomy
Speciality
Code
Description
License number
State
344600000X
Taxi
Primary
55823
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
39335836
—
CO
05
—
86203339
—
CO
Enumeration date
10/08/2015
Last updated
10/02/2021
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