Healthcare Provider Details

I. General information

NPI: 1972259067
Provider Name (Legal Business Name): HALGAN GROUP LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/27/2022
Last Update Date: 02/27/2022
Certification Date: 02/27/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1864 E INNOVATION PARK DR STE 100
ORO VALLEY AZ
85755-1963
US

IV. Provider business mailing address

PO BOX 12872
TEMPE AZ
85284-0048
US

V. Phone/Fax

Practice location:
  • Phone: 480-410-2700
  • Fax:
Mailing address:
  • Phone: 480-410-2700
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code347E00000X
TaxonomyTransportation Broker
License Number
License Number StateNULL
# 3
Primary TaxonomyN
Taxonomy Code342000000X
TaxonomyTransportation Network Company
License Number
License Number StateNULL

VIII. Authorized Official

Name: OSMAN ALI
Title or Position: PRESIDENT
Credential:
Phone: 480-410-2700