Provider Demographics
NPI:1659056802
Name:ZHEWERE, ZEMECHA GOBENA
Entity Type:Individual
Prefix:
First Name:ZEMECHA
Middle Name:GOBENA
Last Name:ZHEWERE
Suffix:
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 1:1321 W HADLEY ST
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85007-4068
Mailing Address - Country:US
Mailing Address - Phone:602-481-9554
Mailing Address - Fax:
Practice Address - Street 1:1321 W HADLEY ST
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85007-4068
Practice Address - Country:US
Practice Address - Phone:602-481-9554
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-06-15
Last Update Date:2023-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZD08950435343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)