Healthcare Provider Details

I. General information

NPI: 1093496689
Provider Name (Legal Business Name): STAR TECH SOLUTIONS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/27/2023
Last Update Date: 07/27/2023
Certification Date: 07/27/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4040 E MCDOWELL RD STE 405
PHOENIX AZ
85008-4448
US

IV. Provider business mailing address

4040 E MCDOWELL RD STE 405
PHOENIX AZ
85008-4448
US

V. Phone/Fax

Practice location:
  • Phone: 480-548-3307
  • Fax:
Mailing address:
  • Phone: 480-548-3307
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code347E00000X
TaxonomyTransportation Broker
License Number
License Number State

VIII. Authorized Official

Name: YALEW TAMRAT
Title or Position: OWNER
Credential:
Phone: 480-548-3307