Healthcare Provider Details

I. General information

NPI: 1801922000
Provider Name (Legal Business Name): CAROL ANN SHARPE TRANSPORTATION
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: LIGHTNING YELLOW TAXI TRANSPORTATION

II. Dates (important events)

Enumeration Date: 02/24/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4295 N BENTON ST
KINGMAN AZ
86409-2640
US

IV. Provider business mailing address

4295 N BENTON ST
KINGMAN AZ
86409-2640
US

V. Phone/Fax

Practice location:
  • Phone: 928-753-4444
  • Fax: 928-692-0233
Mailing address:
  • Phone: 928-692-9746
  • Fax: 928-692-0233

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code344600000X
TaxonomyTaxi
License Number07-2431
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: