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General NPI Number Information
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NPI Number | 1649954769
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Entity Type | Organization
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Legal Business Name | NIZHONI TRANSPORT
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Dates
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Enumeration Date | 06/09/2023
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Last Update Date | 06/09/2023
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Provider Practice Location Address
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Address Line | 909 E CAMELBACK RD # 2046
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City | PHOENIX
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State | AZ
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Zip | 85014-3687
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Country | US
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Telephone | 623-224-3395
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 4516
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City | GALLUP
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State | NM
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Zip | 87305-4516
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Country | US
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Telephone | 623-224-3395
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Fax |
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Authorized Official
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Title or Position | MANAGING MEMBER
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Name | TANYA LIVINGSTON
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Credential |
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Telephone | 623-224-3395
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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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Taxonomy #2
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Taxonomy Code | 343900000X
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Taxonomy Name | Non-emergency Medical Transport (VAN)
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License Number |
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License Number State |
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