Provider Demographics
NPI:1538680798
Name:QUALITY TRANSPORT SOLUTIONS LLC
Entity Type:Organization
Organization Name:QUALITY TRANSPORT SOLUTIONS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SOLE PROPRIETER/OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:HENRIETTA
Authorized Official - Middle Name:
Authorized Official - Last Name:JAJE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:505-215-1751
Mailing Address - Street 1:PO BOX 4530
Mailing Address - Street 2:
Mailing Address - City:WINDOW ROCK
Mailing Address - State:AZ
Mailing Address - Zip Code:86515
Mailing Address - Country:US
Mailing Address - Phone:505-215-1751
Mailing Address - Fax:928-810-3084
Practice Address - Street 1:5 MI S. JCT RD 264 RT 12 MP 23
Practice Address - Street 2:
Practice Address - City:ST. MICHEALS
Practice Address - State:AZ
Practice Address - Zip Code:86511
Practice Address - Country:US
Practice Address - Phone:505-215-1751
Practice Address - Fax:928-810-3084
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-06-28
Last Update Date:2017-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ101866343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ696450Medicaid