Healthcare Provider Details

I. General information

NPI: 1306071220
Provider Name (Legal Business Name): GLOBE TAXI COMPANY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/20/2009
Last Update Date: 05/20/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

150 S PINE ST
GLOBE AZ
85501-2647
US

IV. Provider business mailing address

150 S PINE ST
GLOBE AZ
85501-2647
US

V. Phone/Fax

Practice location:
  • Phone: 928-402-8294
  • Fax: 928-425-2585
Mailing address:
  • Phone: 928-402-8294
  • Fax: 928-425-2585

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code344600000X
TaxonomyTaxi
License NumberL14845637
License Number StateAZ

VIII. Authorized Official

Name: MR. DUSTIN JACOB HODES
Title or Position: GENERAL MANAGER
Credential:
Phone: 928-812-5090