Healthcare Provider Details

I. General information

NPI: 1073213948
Provider Name (Legal Business Name): TANOAN MEDICAL TRANSPORT
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/08/2023
Last Update Date: 03/09/2023
Certification Date: 03/09/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

ISLAND COMMERCIAL BUILDING A, MIDDLE ROAD SUITE #5
SAIPAN MP
96950
US

IV. Provider business mailing address

PO BOX 5126
SAIPAN MP
96950-5126
US

V. Phone/Fax

Practice location:
  • Phone: 671-685-6970
  • Fax:
Mailing address:
  • Phone: 671-685-6970
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: MR. VICENTE C. BORJA
Title or Position: PRESIDENT
Credential:
Phone: 671-685-6970