Healthcare Provider Details

I. General information

NPI: 1467277210
Provider Name (Legal Business Name): EXPRESS ONE TRANSPORTATION LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/18/2024
Last Update Date: 05/16/2025
Certification Date: 05/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2142 W OSBORN RD
PHOENIX AZ
85015-5731
US

IV. Provider business mailing address

2142 W OSBORN RD
PHOENIX AZ
85015-5731
US

V. Phone/Fax

Practice location:
  • Phone: 602-653-4277
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License Number
License Number State

VIII. Authorized Official

Name: MUSTAFA ARBAB
Title or Position: OWNER
Credential:
Phone: 602-653-4277