Provider Demographics
NPI:1073213948
Name:TANOAN MEDICAL TRANSPORT
Entity Type:Organization
Organization Name:TANOAN MEDICAL TRANSPORT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:VICENTE
Authorized Official - Middle Name:C
Authorized Official - Last Name:BORJA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:671-685-6970
Mailing Address - Street 1:PO BOX 5126
Mailing Address - Street 2:
Mailing Address - City:SAIPAN
Mailing Address - State:MP
Mailing Address - Zip Code:96950-5126
Mailing Address - Country:US
Mailing Address - Phone:671-685-6970
Mailing Address - Fax:
Practice Address - Street 1:ISLAND COMMERCIAL BUILDING A, MIDDLE ROAD
Practice Address - Street 2:SUITE #5
Practice Address - City:SAIPAN
Practice Address - State:MP
Practice Address - Zip Code:96950
Practice Address - Country:US
Practice Address - Phone:671-685-6970
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-03-08
Last Update Date:2023-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)