Provider Demographics
NPI:1053612549
Name:ADAPTIVE NON EMERGENCY TRANSPORTATION INC.
Entity type:Organization
Organization Name:ADAPTIVE NON EMERGENCY TRANSPORTATION INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF SERVICES
Authorized Official - Prefix:
Authorized Official - First Name:CARLOS
Authorized Official - Middle Name:
Authorized Official - Last Name:MARRUFO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:505-865-6000
Mailing Address - Street 1:472 COURTHOUSE RD SE
Mailing Address - Street 2:
Mailing Address - City:LOS LUNAS
Mailing Address - State:NM
Mailing Address - Zip Code:87031-9270
Mailing Address - Country:US
Mailing Address - Phone:505-865-6000
Mailing Address - Fax:505-865-6605
Practice Address - Street 1:472 COURTHOUSE RD SE
Practice Address - Street 2:
Practice Address - City:LOS LUNAS
Practice Address - State:NM
Practice Address - Zip Code:87031-9270
Practice Address - Country:US
Practice Address - Phone:505-865-6000
Practice Address - Fax:505-865-6605
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-11-15
Last Update Date:2010-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
Provider Identifiers
StateIdentifier IDID TypeIssuer
NM07436068Medicaid