Healthcare Provider Details

I. General information

NPI: 1780907733
Provider Name (Legal Business Name): APACHE TAXI LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/04/2010
Last Update Date: 03/16/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1945 E APACHE BLVD
TEMPE AZ
85281-6075
US

IV. Provider business mailing address

1945 E APACHE BLVD
TEMPE AZ
85281-6075
US

V. Phone/Fax

Practice location:
  • Phone: 480-804-1000
  • Fax: 480-556-1896
Mailing address:
  • Phone: 480-804-1000
  • Fax: 480-556-1896

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License Number29289
License Number StateAZ
# 2
Primary TaxonomyN
Taxonomy Code344600000X
TaxonomyTaxi
License Number
License Number State

VIII. Authorized Official

Name: MR. ABBAS A NAINI
Title or Position: OWNER
Credential: BS
Phone: 602-697-9008