Provider Demographics
NPI:1750657623
Name:BEGAY, VIRGIL
Entity Type:Individual
Prefix:
First Name:VIRGIL
Middle Name:
Last Name:BEGAY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 5403
Mailing Address - Street 2:
Mailing Address - City:WINDOW ROCK
Mailing Address - State:AZ
Mailing Address - Zip Code:86515-5403
Mailing Address - Country:US
Mailing Address - Phone:505-285-7344
Mailing Address - Fax:928-729-5338
Practice Address - Street 1:NAVAJO RT 12 MM 34-3429
Practice Address - Street 2:
Practice Address - City:WINDOW ROCK
Practice Address - State:AZ
Practice Address - Zip Code:86515-3429
Practice Address - Country:US
Practice Address - Phone:505-285-7344
Practice Address - Fax:928-729-5338
Is Sole Proprietor?:Yes
Enumeration Date:2012-03-26
Last Update Date:2012-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ34343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)