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General NPI Number Information
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NPI Number | 1205127917
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Entity Type | Organization
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Legal Business Name | ON TIME MED TRANS INC
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Dates
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Enumeration Date | 04/28/2011
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Last Update Date | 04/28/2011
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Provider Practice Location Address
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Address Line | 5235 S KYRENE RD STE 19
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City | TEMPE
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State | AZ
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Zip | 85283-1780
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Country | US
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Telephone | 602-330-7833
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Fax | 480-247-7708
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Provider Business Mailing Address
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Address Line | 5235 S KYRENE RD SUITE #19
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City | TEMPE
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State | AZ
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Zip | 85283
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Country | US
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Telephone | 602-330-7833
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Fax | 480-247-7708
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Authorized Official
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Title or Position | CEO
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Name | MR. SAMI TALAB
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Credential |
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Telephone | 602-330-7833
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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 | 14318
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License Number State | AZ
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