MEDICARE: EAGLE CAB LLC.

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	344600000X	Taxi	DO3281690	AZ

General Provider Information

NPI Number	:	1568666790
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	EAGLE CAB LLC.

Provider Business Mailing Address
First Line	:	4040 E MCDOWELL RD
Second Line	:	SUITE 104
City	:	PHOENIX
State	:	AZ
Zip	:	85008-4414
Country	:	US
Telephone Number	:	602-244-0440
Fax Number	:	602-244-0441

Provider Business Practice Location Address
First Line	:	4040 E MCDOWELL RD
Second Line	:	SUITE 104
City	:	PHOENIX
State	:	AZ
Zip	:	85008-4414
Country	:	US
Telephone Number	:	602-244-0440
Fax Number	:	602-244-0441

Authorized Official
Title or Position	:	GENERAL MANAGER
Name	:	MR. NAZARALI SAFAR
Credential	:
Telephone Number	:	602-244-0440

Provider Enumeration Date	:	06/12/2007
Last Update Date	:	08/22/2020

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