MEDICARE: MARIA ANDERSON

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	343900000X	Non-emergency Medical Transport (VAN)	D02359503	AZ

General Provider Information

NPI Number	:	1326363169
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARIA ANDERSON

Provider Business Mailing Address
First Line	:	41335 N ARBOR AVE
Second Line	:
City	:	SAN TAN VALLEY
State	:	AZ
Zip	:	85140-6120
Country	:	US
Telephone Number	:	480-203-2792
Fax Number	:

Provider Business Practice Location Address
First Line	:	41335 N ARBOR AVE
Second Line	:
City	:	SAN TAN VALLEY
State	:	AZ
Zip	:	85140-6120
Country	:	US
Telephone Number	:	480-203-2792
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/05/2010
Last Update Date	:	04/05/2010

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Directions to “ MARIA ANDERSON ” Practice Location

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