Provider Demographics
NPI:1902878754
Name:NAVAJO TRANSPORT SERVICE, INC.
Entity type:Organization
Organization Name:NAVAJO TRANSPORT SERVICE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:ALICE
Authorized Official - Middle Name:SHAUGHNESSY
Authorized Official - Last Name:BEGAY
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:505-327-0851
Mailing Address - Street 1:904 SULLIVAN AVE
Mailing Address - Street 2:
Mailing Address - City:FARMINGTON
Mailing Address - State:NM
Mailing Address - Zip Code:87401-7359
Mailing Address - Country:US
Mailing Address - Phone:505-327-0851
Mailing Address - Fax:505-327-1259
Practice Address - Street 1:904 SULLIVAN AVE
Practice Address - Street 2:
Practice Address - City:FARMINGTON
Practice Address - State:NM
Practice Address - Zip Code:87401-7359
Practice Address - Country:US
Practice Address - Phone:505-327-0851
Practice Address - Fax:505-327-1259
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-02-06
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMICC 248424343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ067993Medicaid
NME8328Medicaid
CO96001227Medicaid
CO96001227Medicaid