Healthcare Provider Details

I. General information

NPI: 1477284321
Provider Name (Legal Business Name): SUADNA MEDICAL TRANSPORTATION LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/22/2022
Last Update Date: 06/30/2022
Certification Date: 06/30/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3106 W VOGEL AVE APT A207
PHOENIX AZ
85051-2637
US

IV. Provider business mailing address

3106 W VOGEL AVE APT A207
PHOENIX AZ
85051-2637
US

V. Phone/Fax

Practice location:
  • Phone: 480-955-8831
  • Fax:
Mailing address:
  • Phone: 480-955-8831
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code342000000X
TaxonomyTransportation Network Company
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code347E00000X
TaxonomyTransportation Broker
License Number
License Number State

VIII. Authorized Official

Name: NAWAL A HASSAN
Title or Position: OFFICE MENEGER
Credential:
Phone: 480-955-8831