Provider Demographics
NPI:1245078609
Name:ARROWHEAD MEDICAL TRANSPORT
Entity type:Organization
Organization Name:ARROWHEAD MEDICAL TRANSPORT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:SAIFELYZAL
Authorized Official - Middle Name:
Authorized Official - Last Name:ALI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:919-771-3680
Mailing Address - Street 1:PO BOX 2888
Mailing Address - Street 2:
Mailing Address - City:WINDOW ROCK
Mailing Address - State:AZ
Mailing Address - Zip Code:86515-2888
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3101 N CENTRAL AVE STE 174
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85012-3613
Practice Address - Country:US
Practice Address - Phone:480-492-1488
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-07-18
Last Update Date:2024-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)