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General NPI Number Information
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NPI Number | 1770903957
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Entity Type | Organization
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Legal Business Name | PANDA CARE LLC
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Dates
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Enumeration Date | 04/25/2014
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Last Update Date | 04/25/2014
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Provider Practice Location Address
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Address Line | 2201 S MCCLINTOCK DR STE 8
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City | TEMPE
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State | AZ
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Zip | 85282-2602
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Country | US
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Telephone | 480-656-0437
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Fax | 480-656-2451
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Provider Business Mailing Address
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Address Line | 2201 S MCCLINTOCK DR STE 8
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City | TEMPE
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State | AZ
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Zip | 85282-2602
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Country | US
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Telephone | 480-656-0437
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Fax | 480-656-2451
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Authorized Official
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Title or Position | OWNER
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Name | AHMED KHAIRALLA
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Credential |
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Telephone | 480-622-7833
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3416L0300X
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Taxonomy Name | Land Ambulance
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License Number |
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License Number State |
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