Provider Demographics
NPI:1770883373
Name:DEMBY, HAROLD SCOTT
Entity type:Individual
Prefix:MR
First Name:HAROLD
Middle Name:SCOTT
Last Name:DEMBY
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17222 N CENTRAL AVE
Mailing Address - Street 2:119
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85022-2334
Mailing Address - Country:US
Mailing Address - Phone:480-558-6402
Mailing Address - Fax:623-478-7745
Practice Address - Street 1:17222 N CENTRAL AVE
Practice Address - Street 2:119
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85022-2334
Practice Address - Country:US
Practice Address - Phone:480-558-6402
Practice Address - Fax:623-478-7745
Is Sole Proprietor?:Yes
Enumeration Date:2010-10-28
Last Update Date:2010-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZD06056749343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)