Healthcare Provider Details

I. General information

NPI: 1114224581
Provider Name (Legal Business Name): CDE TRANSPORTATION & SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/22/2011
Last Update Date: 02/22/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

220 W PAPAGO WAY
COCHISE AZ
85606-8714
US

IV. Provider business mailing address

220 W PAPAGO WAY
COCHISE AZ
85606-8714
US

V. Phone/Fax

Practice location:
  • Phone: 520-826-3449
  • Fax: 520-826-1716
Mailing address:
  • Phone: 520-826-3449
  • Fax: 520-826-1716

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License Number
License Number State

VIII. Authorized Official

Name: MRS. BARBARA ANN HART
Title or Position: PRESIDENT
Credential: LPN
Phone: 520-826-3449