Provider Demographics
NPI:1760080618
Name:HUMBOLDT APPOINTMENT TRANSPORT LLC
Entity Type:Organization
Organization Name:HUMBOLDT APPOINTMENT TRANSPORT LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:
Authorized Official - Last Name:ROYBAL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:707-273-1313
Mailing Address - Street 1:PO BOX 2842
Mailing Address - Street 2:
Mailing Address - City:MCKINLEYVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:95519-2842
Mailing Address - Country:US
Mailing Address - Phone:707-273-1313
Mailing Address - Fax:
Practice Address - Street 1:4514 VALLEY WEST BLVD
Practice Address - Street 2:
Practice Address - City:ARCATA
Practice Address - State:CA
Practice Address - Zip Code:95521-7443
Practice Address - Country:US
Practice Address - Phone:707-273-1313
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-10-13
Last Update Date:2020-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)