Provider Demographics
NPI:1730126244
Name:MEHARI TRANSPORTATION
Entity Type:Organization
Organization Name:MEHARI TRANSPORTATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:MEHARI
Authorized Official - Middle Name:CAHSAI
Authorized Official - Last Name:KIDANE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:602-577-4419
Mailing Address - Street 1:PO BOX 97628
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85060
Mailing Address - Country:US
Mailing Address - Phone:602-577-4419
Mailing Address - Fax:602-274-0452
Practice Address - Street 1:1829 E FAIRMOUNT AVE
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85016
Practice Address - Country:US
Practice Address - Phone:602-577-4419
Practice Address - Fax:602-274-0452
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-01
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)