Provider Demographics
NPI:1346927209
Name:SWAN TRANS LLC
Entity Type:Organization
Organization Name:SWAN TRANS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:MOHAMED
Authorized Official - Middle Name:A
Authorized Official - Last Name:MOHAMUD
Authorized Official - Suffix:
Authorized Official - Credentials:N/A
Authorized Official - Phone:505-470-8132
Mailing Address - Street 1:5401 E VAN BUREN ST UNIT 3054
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85008-3469
Mailing Address - Country:US
Mailing Address - Phone:505-470-8132
Mailing Address - Fax:
Practice Address - Street 1:1012 MARQUEZ PL UNIT 106B
Practice Address - Street 2:
Practice Address - City:SANTA FE
Practice Address - State:NM
Practice Address - Zip Code:87505-1833
Practice Address - Country:US
Practice Address - Phone:505-470-8132
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-07-03
Last Update Date:2023-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)