Provider Demographics
NPI:1578732178
Name:NETCOR TRANSPORTS LLC
Entity Type:Organization
Organization Name:NETCOR TRANSPORTS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROGRAM DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:RAFAEL
Authorized Official - Middle Name:G
Authorized Official - Last Name:CORTEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:480-688-9497
Mailing Address - Street 1:PO BOX 14449
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85063-4449
Mailing Address - Country:US
Mailing Address - Phone:623-243-7245
Mailing Address - Fax:480-522-3608
Practice Address - Street 1:1010 E INDIAN SCHOOL RD
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85014-4810
Practice Address - Country:US
Practice Address - Phone:623-243-7245
Practice Address - Fax:480-522-3608
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-27
Last Update Date:2008-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ249302OtherAHCCCS
AZ249302Medicaid