MEDICARE: TRIBALIGHTS INM LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	343900000X	Non-emergency Medical Transport (VAN)
2	344600000X	Taxi

General Provider Information

NPI Number	:	1114859469
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TRIBALIGHTS INM LLC

Provider Business Mailing Address
First Line	:	101 CORONADO LN
Second Line	:
City	:	SANTA FE
State	:	NM
Zip	:	87505-2685
Country	:	US
Telephone Number	:	310-721-4398
Fax Number	:

Provider Business Practice Location Address
First Line	:	101 CORONADO LN
Second Line	:
City	:	SANTA FE
State	:	NM
Zip	:	87505-2685
Country	:	US
Telephone Number	:	310-721-4398
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	PHOENIX GERMANO
Credential	:
Telephone Number	:	310-721-4398

Provider Enumeration Date	:	06/01/2026
Last Update Date	:	06/02/2026

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Directions to “TRIBALIGHTS INM LLC ” Practice Location

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