Provider Demographics
NPI:1750667515
Name:ARIZONA WORLD
Entity Type:Organization
Organization Name:ARIZONA WORLD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:JUDE
Authorized Official - Middle Name:AZNAR
Authorized Official - Last Name:TADEO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:520-458-3330
Mailing Address - Street 1:53 N GARDEN AVE
Mailing Address - Street 2:
Mailing Address - City:SIERRA VISTA
Mailing Address - State:AZ
Mailing Address - Zip Code:85635-3805
Mailing Address - Country:US
Mailing Address - Phone:520-458-3330
Mailing Address - Fax:520-458-4085
Practice Address - Street 1:53 N GARDEN AVE
Practice Address - Street 2:
Practice Address - City:SIERRA VISTA
Practice Address - State:AZ
Practice Address - Zip Code:85635-3805
Practice Address - Country:US
Practice Address - Phone:520-458-3330
Practice Address - Fax:520-458-4085
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-10-25
Last Update Date:2011-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ1100000171343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)