Healthcare Provider Details

I. General information

NPI: 1821262205
Provider Name (Legal Business Name): J&M TRANSPORTATION, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/16/2008
Last Update Date: 04/16/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1346 E LAUREL PL
CASA GRANDE AZ
85222-1393
US

IV. Provider business mailing address

1346 E LAUREL PL
CASA GRANDE AZ
85222-1393
US

V. Phone/Fax

Practice location:
  • Phone: 520-836-6585
  • Fax: 520-423-3151
Mailing address:
  • Phone: 520-836-6585
  • Fax: 520-423-3151

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code344600000X
TaxonomyTaxi
License NumberBMF 573
License Number StateAZ

VIII. Authorized Official

Name: MR. DANIEL JOHN ROMERO
Title or Position: OWNER
Credential:
Phone: 520-836-6585