Provider Demographics
NPI:1639882343
Name:CALVIN, RICHARD LEE II
Entity Type:Individual
Prefix:MR
First Name:RICHARD
Middle Name:LEE
Last Name:CALVIN
Suffix:II
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7037 W SHEILA LN
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85033-4438
Mailing Address - Country:US
Mailing Address - Phone:718-812-4338
Mailing Address - Fax:
Practice Address - Street 1:7037 W SHEILA LN
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85033-4438
Practice Address - Country:US
Practice Address - Phone:718-812-4338
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-12-28
Last Update Date:2022-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)