Provider Demographics
NPI:1083861173
Name:CACTUS EXPRSS E.M.S LLC
Entity Type:Organization
Organization Name:CACTUS EXPRSS E.M.S LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ONWER
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:E
Authorized Official - Last Name:UWAJEH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:520-245-3056
Mailing Address - Street 1:8665 E . SPEEDWAY
Mailing Address - Street 2:#1111
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85710
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:8665 E SPEEDWAY BLVD APT 1111
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85710-1764
Practice Address - Country:US
Practice Address - Phone:520-245-3056
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-08-20
Last Update Date:2008-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)