Healthcare Provider Details

I. General information

NPI: 1861742595
Provider Name (Legal Business Name): PAPAGO TRANSPORT SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/10/2012
Last Update Date: 09/10/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5302 E VAN BUREN ST 2015
PHOENIX AZ
85008-7965
US

IV. Provider business mailing address

5302 E VAN BUREN ST 2015
PHOENIX AZ
85008-7965
US

V. Phone/Fax

Practice location:
  • Phone: 602-573-2627
  • Fax:
Mailing address:
  • Phone: 602-573-2627
  • 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 Code344600000X
TaxonomyTaxi
License Number
License Number State

VIII. Authorized Official

Name: MR. ISMAIL MOHAMED ISMAIL
Title or Position: OWNER
Credential:
Phone: 602-573-2627