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General NPI Number Information
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NPI Number | 1639024557
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Entity Type | Organization
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Legal Business Name | MEDGO MEDICAL TRANSPORTATION LLC
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Dates
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Enumeration Date | 03/04/2026
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Last Update Date | 03/04/2026
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Provider Practice Location Address
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Address Line | 5422 W THUNDERBIRD RD STE 2
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City | GLENDALE
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State | AZ
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Zip | 85306-4717
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Country | US
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Telephone | 619-576-4865
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Fax |
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Provider Business Mailing Address
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Address Line | 5422 W THUNDERBIRD RD STE 2
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City | GLENDALE
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State | AZ
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Zip | 85306-4717
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | VANG SENGALOUNE
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Credential |
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Telephone | 619-576-4865
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 342000000X
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Taxonomy Name | Transportation Network Company
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License Number |
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License Number State |
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