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General NPI Number Information
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NPI Number | 1659668424
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Entity Type | Organization
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Legal Business Name | AZ SECURE TRANS LLC
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Dates
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Enumeration Date | 06/30/2011
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Last Update Date | 06/30/2011
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Provider Practice Location Address
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Address Line | 2131 E BROADWAY RD SUITE #4
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City | TEMPE
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State | AZ
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Zip | 85282-1737
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Country | US
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Telephone | 480-381-7307
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Fax | 480-247-6304
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Provider Business Mailing Address
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Address Line | 2131 E BROADWAY RD SUITE #4
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City | TEMPE
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State | AZ
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Zip | 85282-1737
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Country | US
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Telephone | 480-381-7307
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Fax | 480-247-6304
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. SANJAY CHOWDHURY
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Credential |
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Telephone | 480-381-7307
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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 | BMF #: 36291
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License Number State | AZ
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