Provider Demographics
NPI:1578744207
Name:ARIZONA CARE MEDICAL TRANS LLC.
Entity Type:Organization
Organization Name:ARIZONA CARE MEDICAL TRANS LLC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ESSAM
Authorized Official - Middle Name:M
Authorized Official - Last Name:ELMUBARAK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:602-903-8383
Mailing Address - Street 1:4397 W BETHANY HOME RD # 1037
Mailing Address - Street 2:
Mailing Address - City:GLENDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85301-5401
Mailing Address - Country:US
Mailing Address - Phone:602-903-8383
Mailing Address - Fax:602-795-5181
Practice Address - Street 1:4397 W BETHANY HOME RD # 1037
Practice Address - Street 2:
Practice Address - City:GLENDALE
Practice Address - State:AZ
Practice Address - Zip Code:85301-5401
Practice Address - Country:US
Practice Address - Phone:602-903-8383
Practice Address - Fax:602-795-5181
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-22
Last Update Date:2007-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)