Healthcare Provider Details

I. General information

NPI: 1437408564
Provider Name (Legal Business Name): DESERT CARETRANSPORTATION LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/05/2012
Last Update Date: 09/05/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1969 E STEPHENS DR
TEMPE AZ
85283-4916
US

IV. Provider business mailing address

1969 E STEPHENS DR
TEMPE AZ
85283-4916
US

V. Phone/Fax

Practice location:
  • Phone: 480-231-0084
  • Fax:
Mailing address:
  • Phone: 480-231-0084
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License NumberCH13286
License Number StateAZ

VIII. Authorized Official

Name: ANJUM ALIMOHAMMED
Title or Position: OWNER
Credential:
Phone: 480-231-0084