Provider Demographics
NPI:1225168842
Name:FAUST'S TRANSPORTATION, INC.
Entity Type:Organization
Organization Name:FAUST'S TRANSPORTATION, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPERATIONS MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:LORETTA
Authorized Official - Middle Name:E
Authorized Official - Last Name:GONZALES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:505-758-3410
Mailing Address - Street 1:PO BOX 1050
Mailing Address - Street 2:
Mailing Address - City:EL PRADO
Mailing Address - State:NM
Mailing Address - Zip Code:87529-1050
Mailing Address - Country:US
Mailing Address - Phone:505-758-3410
Mailing Address - Fax:505-758-1418
Practice Address - Street 1:1010 FAUST LANE
Practice Address - Street 2:
Practice Address - City:EL PRADO
Practice Address - State:NM
Practice Address - Zip Code:87529-1050
Practice Address - Country:US
Practice Address - Phone:505-758-3410
Practice Address - Fax:505-758-1418
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-06
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM10723343900000X, 344600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
Not Answered344600000XTransportation ServicesTaxi
Provider Identifiers
StateIdentifier IDID TypeIssuer
NMF3208Medicaid