MEDICARE: MR. MUSA RAHAL RAHAL

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)	3020443	AZ

General Provider Information

NPI Number	:	1629342589
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. MUSA RAHAL RAHAL

Provider Business Mailing Address
First Line	:	1116 S 11TH AVE UNIT 2
Second Line	:
City	:	TUCSON
State	:	AZ
Zip	:	85701-3323
Country	:	US
Telephone Number	:	520-409-5435
Fax Number	:

Provider Business Practice Location Address
First Line	:	1116 S 11TH AVE UNIT 2
Second Line	:
City	:	TUCSON
State	:	AZ
Zip	:	85701-3323
Country	:	US
Telephone Number	:	520-409-5435
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/23/2012
Last Update Date	:	02/23/2012

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Directions to “ MR. MUSA RAHAL RAHAL ” Practice Location

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