Provider Demographics
NPI:1043062839
Name:MARANGO, ERIK (BHT)
Entity Type:Individual
Prefix:
First Name:ERIK
Middle Name:
Last Name:MARANGO
Suffix:
Gender:M
Credentials:BHT
Other - Prefix:
Other - First Name:ZHAN ZHAK ERIK
Other - Middle Name:
Other - Last Name:MARANGO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:BHT
Mailing Address - Street 1:691 E CHRISTOPHER ST
Mailing Address - Street 2:
Mailing Address - City:SAN TAN VALLEY
Mailing Address - State:AZ
Mailing Address - Zip Code:85140-5743
Mailing Address - Country:US
Mailing Address - Phone:207-409-0895
Mailing Address - Fax:
Practice Address - Street 1:691 E CHRISTOPHER ST
Practice Address - Street 2:
Practice Address - City:SAN TAN VALLEY
Practice Address - State:AZ
Practice Address - Zip Code:85140-5743
Practice Address - Country:US
Practice Address - Phone:207-409-0895
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-04-04
Last Update Date:2024-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)