Healthcare Provider Details

I. General information

NPI: 1124501333
Provider Name (Legal Business Name): TYMON LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/13/2018
Last Update Date: 09/13/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6101 S RURAL RD STE 101
TEMPE AZ
85283-2910
US

IV. Provider business mailing address

8016 S 32ND WAY
PHOENIX AZ
85042-9665
US

V. Phone/Fax

Practice location:
  • Phone: 480-232-8025
  • Fax: 480-517-4828
Mailing address:
  • Phone: 480-232-8025
  • Fax: 480-517-4828

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: AYMEN B ABDELHABIB
Title or Position: GENERAL MANAGER
Credential:
Phone: 480-201-3383