Provider Demographics
NPI:1811339179
Name:MORNING STAR TRANSPORT
Entity type:Organization
Organization Name:MORNING STAR TRANSPORT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:ARLENE
Authorized Official - Middle Name:SUE
Authorized Official - Last Name:WILLIAMS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:928-313-2901
Mailing Address - Street 1:PO BOX 03
Mailing Address - Street 2:
Mailing Address - City:ROUND ROCK
Mailing Address - State:AZ
Mailing Address - Zip Code:86547
Mailing Address - Country:US
Mailing Address - Phone:928-313-2901
Mailing Address - Fax:
Practice Address - Street 1:HWY 191/NAVAJO ROUTE 12 MILE POST 477
Practice Address - Street 2:1.25 S OF ROUND ROCK TRADING POST
Practice Address - City:ROUND ROCK
Practice Address - State:AZ
Practice Address - Zip Code:86547
Practice Address - Country:US
Practice Address - Phone:928-313-2901
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-07-26
Last Update Date:2013-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZATB9495343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)