Provider Demographics
NPI:1336874015
Name:TRUCK LINE LLC DBA ALL AZ MED TRANS
Entity Type:Organization
Organization Name:TRUCK LINE LLC DBA ALL AZ MED TRANS
Other - Org Name:DBA ALL MAZ MED TRANS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANEGER
Authorized Official - Prefix:
Authorized Official - First Name:AHMED
Authorized Official - Middle Name:
Authorized Official - Last Name:ALI
Authorized Official - Suffix:I
Authorized Official - Credentials:
Authorized Official - Phone:205-207-7777
Mailing Address - Street 1:3300 N 7TH AVE UNIT 131
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85013-4185
Mailing Address - Country:US
Mailing Address - Phone:205-207-7777
Mailing Address - Fax:
Practice Address - Street 1:3300 N 7TH AVE UNIT 131
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85013-4185
Practice Address - Country:US
Practice Address - Phone:205-207-7777
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-07-18
Last Update Date:2023-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)