Provider Demographics
NPI:1710119599
Name:CHOICE CARE TRANSPORTATION
Entity Type:Organization
Organization Name:CHOICE CARE TRANSPORTATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ADMINISTRATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:JACQUIN
Authorized Official - Middle Name:
Authorized Official - Last Name:WEATHERSPOON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:480-227-7117
Mailing Address - Street 1:2320 E BASELINE RD
Mailing Address - Street 2:SUITE 148-139
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85042-6951
Mailing Address - Country:US
Mailing Address - Phone:480-206-9252
Mailing Address - Fax:602-889-8887
Practice Address - Street 1:925 E BEAUTIFUL LN
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85042-6603
Practice Address - Country:US
Practice Address - Phone:480-206-9252
Practice Address - Fax:602-889-8887
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-08-12
Last Update Date:2009-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)