Healthcare Provider Details

I. General information

NPI: 1205146339
Provider Name (Legal Business Name): STATE CAB INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/07/2010
Last Update Date: 10/07/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6636 S FOREST AVE
TEMPE AZ
85283-3620
US

IV. Provider business mailing address

6636 S. FOREST AVE
TEMPE AZ
85283
US

V. Phone/Fax

Practice location:
  • Phone: 602-435-4443
  • Fax:
Mailing address:
  • Phone:
  • 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. SAMI TALAB
Title or Position: CEO
Credential:
Phone: 602-435-4443