Provider Demographics
NPI:1659065050
Name:COACHELLA VALLEY NOT EMERGENCY MEDICAL TRANSPORTATION LLC
Entity Type:Organization
Organization Name:COACHELLA VALLEY NOT EMERGENCY MEDICAL TRANSPORTATION LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:LARRY
Authorized Official - Middle Name:F
Authorized Official - Last Name:VILLALOBOS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:760-424-6574
Mailing Address - Street 1:576 S WILLIAMS RD
Mailing Address - Street 2:
Mailing Address - City:PALM SPRINGS
Mailing Address - State:CA
Mailing Address - Zip Code:92264-1551
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:576 S WILLIAMS RD
Practice Address - Street 2:
Practice Address - City:PALM SPRINGS
Practice Address - State:CA
Practice Address - Zip Code:92264-1551
Practice Address - Country:US
Practice Address - Phone:442-361-5343
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:COACHELLA VALLE TAXI LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2023-06-07
Last Update Date:2023-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)