Provider Demographics
NPI:1780907733
Name:APACHE TAXI LLC
Entity type:Organization
Organization Name:APACHE TAXI LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:ABBAS
Authorized Official - Middle Name:A
Authorized Official - Last Name:NAINI
Authorized Official - Suffix:
Authorized Official - Credentials:BS
Authorized Official - Phone:602-697-9008
Mailing Address - Street 1:1945 E APACHE BLVD
Mailing Address - Street 2:
Mailing Address - City:TEMPE
Mailing Address - State:AZ
Mailing Address - Zip Code:85281-6075
Mailing Address - Country:US
Mailing Address - Phone:480-804-1000
Mailing Address - Fax:480-556-1896
Practice Address - Street 1:1945 E APACHE BLVD
Practice Address - Street 2:
Practice Address - City:TEMPE
Practice Address - State:AZ
Practice Address - Zip Code:85281-6075
Practice Address - Country:US
Practice Address - Phone:480-804-1000
Practice Address - Fax:480-556-1896
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-03-04
Last Update Date:2010-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
344600000X
AZ29289343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
No344600000XTransportation ServicesTaxi
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ29289OtherDEPT. OF WEIGHTS AND MEASURES
AZ502106OtherAHCCCS