Provider Demographics
NPI:1396059283
Name:DESERT STAR SHUTTLE SERVICES
Entity type:Organization
Organization Name:DESERT STAR SHUTTLE SERVICES
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:RICARDO
Authorized Official - Middle Name:
Authorized Official - Last Name:VALENZUELA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:915-539-6998
Mailing Address - Street 1:1109 LOMALAND DR
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79907-1402
Mailing Address - Country:US
Mailing Address - Phone:915-539-6998
Mailing Address - Fax:
Practice Address - Street 1:1109 LOMALAND DR
Practice Address - Street 2:
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79907-1402
Practice Address - Country:US
Practice Address - Phone:915-539-6998
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-08-03
Last Update Date:2010-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)