Provider Demographics
NPI:1215251715
Name:DNMEDTRANS
Entity type:Organization
Organization Name:DNMEDTRANS
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:TRANSPORTATION
Authorized Official - Prefix:MR
Authorized Official - First Name:AMMAR
Authorized Official - Middle Name:ABD
Authorized Official - Last Name:ADAM
Authorized Official - Suffix:II
Authorized Official - Credentials:MEDICARE
Authorized Official - Phone:602-405-2241
Mailing Address - Street 1:3825 W MCDOWELL RD
Mailing Address - Street 2:3825 W. MCDOWELL RD
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85009-2208
Mailing Address - Country:US
Mailing Address - Phone:602-405-2241
Mailing Address - Fax:602-595-0702
Practice Address - Street 1:3825 W MCDOWELL RD
Practice Address - Street 2:512
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85009-2208
Practice Address - Country:US
Practice Address - Phone:602-405-2241
Practice Address - Fax:602-595-0702
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:DNMEDTRANS
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2010-03-26
Last Update Date:2010-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ320971343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)