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General NPI Number Information
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NPI Number | 1699023952
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Entity Type | Organization
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Legal Business Name | TARA TRANS
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Dates
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Enumeration Date | 08/16/2012
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Last Update Date | 08/16/2012
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Provider Practice Location Address
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Address Line | 8237 E MCDONALD DR
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City | SCOTTSDALE
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State | AZ
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Zip | 85250-6217
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Country | US
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Telephone | 480-228-4098
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Fax |
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Provider Business Mailing Address
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Address Line | 8237 E MCDONALD DR
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City | SCOTTSDALE
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State | AZ
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Zip | 85250-6217
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Country | US
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Telephone | 480-228-4098
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Fax | 480-323-2374
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Authorized Official
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Title or Position | CEO
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Name | GALALELDIN EISSA OMAR
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Credential |
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Telephone | 480-228-4098
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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 | L17496308
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License Number State | AZ
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