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General NPI Number Information
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NPI Number | 1083911200
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Entity Type | Organization
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Legal Business Name | EXCEL SERVICES
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Dates
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Enumeration Date | 02/24/2011
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Last Update Date | 02/24/2011
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Provider Practice Location Address
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Address Line | 14648 W MOLLY LN
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City | SURPRISE
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State | AZ
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Zip | 85387-6635
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Country | US
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Telephone | 623-512-0322
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Fax | 801-340-1048
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Provider Business Mailing Address
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Address Line | 14648 W MOLLY LN
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City | SURPRISE
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State | AZ
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Zip | 85387-6635
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Country | US
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Telephone | 623-512-0322
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Fax | 801-340-1048
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Authorized Official
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Title or Position | OWNER
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Name | MR. BARRY D CAVANAUGH
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Credential |
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Telephone | 623-512-0322
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 343900000X
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Taxonomy Name | Non-emergency Medical Transport (VAN)
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License Number | D01915479
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License Number State | AZ
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