Provider Demographics
NPI:1003489733
Name:SHARIF JOES TRANSPORT, LLC
Entity Type:Organization
Organization Name:SHARIF JOES TRANSPORT, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:KELLY
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:D'AMICO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:480-206-7659
Mailing Address - Street 1:1955 W COOL WATER WAY
Mailing Address - Street 2:
Mailing Address - City:QUEEN CREEK
Mailing Address - State:AZ
Mailing Address - Zip Code:85142
Mailing Address - Country:US
Mailing Address - Phone:480-206-7659
Mailing Address - Fax:
Practice Address - Street 1:1955 W COOL WATER WAY
Practice Address - Street 2:
Practice Address - City:QUEEN CREEK
Practice Address - State:AZ
Practice Address - Zip Code:85142
Practice Address - Country:US
Practice Address - Phone:480-206-7659
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-07-20
Last Update Date:2021-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date: