Provider Demographics
NPI:1568556785
Name:SATELLITE TRANSPORTATION SVC LLC
Entity Type:Organization
Organization Name:SATELLITE TRANSPORTATION SVC LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:REGIONAL COORDINATOR
Authorized Official - Prefix:
Authorized Official - First Name:DEBI
Authorized Official - Middle Name:
Authorized Official - Last Name:MCKINNEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:602-996-0105
Mailing Address - Street 1:19401 N CAVE CREEK ROAD
Mailing Address - Street 2:SUITE 18
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85024
Mailing Address - Country:US
Mailing Address - Phone:602-274-7375
Mailing Address - Fax:602-274-6373
Practice Address - Street 1:635 W INDIAN SCHOOL ROAD
Practice Address - Street 2:SUITE 107
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85013
Practice Address - Country:US
Practice Address - Phone:602-274-7375
Practice Address - Fax:602-274-6373
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-03
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ973570OtherAHCCCS