MEDICARE: GARIBAY'S MEDICAL TRANSPORT INC

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)

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1891912325
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GARIBAY'S MEDICAL TRANSPORT INC

Provider Business Mailing Address
First Line	:	1837 S MESA DR
Second Line	:	SUITE A202
City	:	MESA
State	:	AZ
Zip	:	85210-6246
Country	:	US
Telephone Number	:	480-948-4655
Fax Number	:	623-258-4311

Provider Business Practice Location Address
First Line	:	1837 S MESA DR
Second Line	:	SUITE A202
City	:	MESA
State	:	AZ
Zip	:	85210-6246
Country	:	US
Telephone Number	:	480-948-4655
Fax Number	:	623-258-4311

Authorized Official
Title or Position	:	COO
Name	:	MR. MICHAEL V SUMNER
Credential	:
Telephone Number	:	480-948-4655

Provider Enumeration Date	:	04/19/2007
Last Update Date	:	11/02/2011

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