Provider Demographics
NPI:1376019406
Name:NAVAJO CARE TRANS LLC
Entity Type:Organization
Organization Name:NAVAJO CARE 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:
Authorized Official - Last Name:MOHAMED
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:602-412-8798
Mailing Address - Street 1:509 S 48TH ST STE 102
Mailing Address - Street 2:
Mailing Address - City:TEMPE
Mailing Address - State:AZ
Mailing Address - Zip Code:85281-2322
Mailing Address - Country:US
Mailing Address - Phone:844-437-8594
Mailing Address - Fax:866-577-8431
Practice Address - Street 1:509 S 48TH ST STE 102
Practice Address - Street 2:
Practice Address - City:TEMPE
Practice Address - State:AZ
Practice Address - Zip Code:85281-2322
Practice Address - Country:US
Practice Address - Phone:844-437-8594
Practice Address - Fax:866-577-8431
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-10-16
Last Update Date:2018-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ469951Medicaid