Provider Demographics
NPI:1134268402
Name:JUST FOR YOU TRANSPORTATION SERVICE, INC.
Entity type:Organization
Organization Name:JUST FOR YOU TRANSPORTATION SERVICE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:WILLIE
Authorized Official - Middle Name:EARL
Authorized Official - Last Name:GRAY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:602-477-8256
Mailing Address - Street 1:PO BOX 21322
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85036-1322
Mailing Address - Country:US
Mailing Address - Phone:602-477-8256
Mailing Address - Fax:602-477-8304
Practice Address - Street 1:917 E BUCKEYE RD
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85034-4038
Practice Address - Country:US
Practice Address - Phone:602-477-8256
Practice Address - Fax:602-477-8304
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-05
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ405482OtherAHCCCS PROVIDER ID #