Provider Demographics
NPI:1508329350
Name:ALASOW, ELMI
Entity Type:Individual
Prefix:
First Name:ELMI
Middle Name:
Last Name:ALASOW
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5134 WEST APOLLO ROAD
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85339
Mailing Address - Country:US
Mailing Address - Phone:602-517-7077
Mailing Address - Fax:
Practice Address - Street 1:5134 W APOLLO RD
Practice Address - Street 2:
Practice Address - City:LAVEEN
Practice Address - State:AZ
Practice Address - Zip Code:85339-6909
Practice Address - Country:US
Practice Address - Phone:602-517-7077
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-04-09
Last Update Date:2019-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)