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General NPI Number Information
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NPI Number | 1962190694
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Entity Type | Organization
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Legal Business Name | 5 C LLC
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Dates
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Enumeration Date | 05/01/2023
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Last Update Date | 05/01/2023
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Provider Practice Location Address
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Address Line | 25827 W DUNLAP RD
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City | BUCKEYE
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State | AZ
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Zip | 85326-9149
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Country | US
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Telephone | 720-585-5678
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Fax |
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Provider Business Mailing Address
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Address Line | 25827 W DUNLAP RD
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City | BUCKEYE
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State | AZ
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Zip | 85326-9149
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Country | US
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Telephone | 720-585-5678
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MILKIAS HAILU
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Credential |
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Telephone | 720-585-5678
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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 |
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License Number State |
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