Healthcare Provider Details

I. General information

NPI: 1720096589
Provider Name (Legal Business Name): HAMANA ENTERPRISES,INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/04/2006
Last Update Date: 06/02/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

WEST POST OFFICE ROAD
KYKOTSMOVI AZ
86039
US

IV. Provider business mailing address

P.O BOX 446
KYKOTSMOVI AZ
86039
US

V. Phone/Fax

Practice location:
  • Phone: 928-734-1282
  • Fax: 928-734-5489
Mailing address:
  • Phone: 928-734-1282
  • Fax: 928-734-5489

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: MR. BRUCE HAMANA
Title or Position: PRESIDENT
Credential:
Phone: 928-734-1282