Healthcare Provider Details

I. General information

NPI: 1881907558
Provider Name (Legal Business Name): ARIZONA SUNSHINE TRANSPORTATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/22/2010
Last Update Date: 07/22/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1350 W KIMBERLY ST APT 213
TUCSON AZ
85704-1594
US

IV. Provider business mailing address

1350 W KIMBERLY ST APT 213
TUCSON AZ
85704-1594
US

V. Phone/Fax

Practice location:
  • Phone: 520-272-9564
  • Fax:
Mailing address:
  • Phone: 520-272-9564
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code344600000X
TaxonomyTaxi
License Number3011722
License Number StateAZ
# 2
Primary TaxonomyY
Taxonomy Code347C00000X
TaxonomyPrivate Vehicle
License Number3011722
License Number StateAZ

VIII. Authorized Official

Name: MR. ADAM TOUNKARA
Title or Position: OWNER
Credential:
Phone: 520-272-9564