Provider Demographics
NPI:1518364561
Name:MEDICAL TRANSPORTATION COMPANY OF TUCSON, LLC
Entity Type:Organization
Organization Name:MEDICAL TRANSPORTATION COMPANY OF TUCSON, LLC
Other - Org Name:MEDICAL TRANSPORT COMPANY OF TUCSON
Other - Org Type:Doing Business As
Authorized Official - Title/Position:GENERAL MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:BRADY
Authorized Official - Middle Name:S
Authorized Official - Last Name:GARRARD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:480-278-1882
Mailing Address - Street 1:2480 W RUTHRAUFF RD
Mailing Address - Street 2:STE 140B
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85705-1976
Mailing Address - Country:US
Mailing Address - Phone:520-999-8900
Mailing Address - Fax:888-421-8813
Practice Address - Street 1:2480 W RUTHRAUFF RD
Practice Address - Street 2:STE 140B
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85705-1976
Practice Address - Country:US
Practice Address - Phone:520-999-8900
Practice Address - Fax:888-421-8813
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-11-19
Last Update Date:2014-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVNV20141478150343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)