Provider Demographics
NPI:1184240954
Name:EXTREME MEDICAL TRANSPORTATION
Entity type:Organization
Organization Name:EXTREME MEDICAL TRANSPORTATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AUTHORIZE OF ORGANIZATION
Authorized Official - Prefix:MRS
Authorized Official - First Name:MALIKIA
Authorized Official - Middle Name:
Authorized Official - Last Name:AMEER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:602-580-5177
Mailing Address - Street 1:34000 N 27TH DR UNIT 3069
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85085-6646
Mailing Address - Country:US
Mailing Address - Phone:602-580-5177
Mailing Address - Fax:
Practice Address - Street 1:34000 N 27TH DR UNIT 3069
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85085-6646
Practice Address - Country:US
Practice Address - Phone:602-580-5177
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-06-17
Last Update Date:2020-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)