Provider Demographics
NPI:1134864374
Name:ARIZONA GROUND MEDICAL TRANSPORT
Entity type:Organization
Organization Name:ARIZONA GROUND MEDICAL TRANSPORT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:L
Authorized Official - Last Name:DAVIS
Authorized Official - Suffix:II
Authorized Official - Credentials:RN, CCM
Authorized Official - Phone:702-931-1919
Mailing Address - Street 1:3645 W OQUENDO RD STE 400
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89118-3145
Mailing Address - Country:US
Mailing Address - Phone:702-931-1919
Mailing Address - Fax:702-979-9292
Practice Address - Street 1:19401 N CAVE CREEK RD STE 8
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85024-1802
Practice Address - Country:US
Practice Address - Phone:480-939-5555
Practice Address - Fax:480-393-0801
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-05-02
Last Update Date:2022-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes342000000XTransportation ServicesTransportation Network Company