Provider Demographics
NPI:1720373582
Name:AMBUCARE TUMN LLC
Entity Type:Organization
Organization Name:AMBUCARE TUMN LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:MRS
Authorized Official - First Name:MARIA
Authorized Official - Middle Name:
Authorized Official - Last Name:CELAYA KOLB
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:480-969-0123
Mailing Address - Street 1:8919 E PAMPA AVE
Mailing Address - Street 2:
Mailing Address - City:MESA
Mailing Address - State:AZ
Mailing Address - Zip Code:85212-2834
Mailing Address - Country:US
Mailing Address - Phone:480-969-0123
Mailing Address - Fax:
Practice Address - Street 1:8919 E PAMPA AVE
Practice Address - Street 2:
Practice Address - City:MESA
Practice Address - State:AZ
Practice Address - Zip Code:85212-2834
Practice Address - Country:US
Practice Address - Phone:480-969-0123
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-06-09
Last Update Date:2011-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZL16361245343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)