Provider Demographics
NPI:1841464138
Name:TRANS4MED, PLLC
Entity type:Organization
Organization Name:TRANS4MED, PLLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT / CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:NATASHA
Authorized Official - Middle Name:
Authorized Official - Last Name:DEONARAIN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:480-855-7585
Mailing Address - Street 1:2815 S ALMA SCHOOL RD
Mailing Address - Street 2:SUITE 7
Mailing Address - City:CHANDLER
Mailing Address - State:AZ
Mailing Address - Zip Code:85286-7706
Mailing Address - Country:US
Mailing Address - Phone:480-855-7585
Mailing Address - Fax:480-855-7803
Practice Address - Street 1:2062 WILLOW CREEK RD
Practice Address - Street 2:
Practice Address - City:PRESCOTT
Practice Address - State:AZ
Practice Address - Zip Code:86301-5389
Practice Address - Country:US
Practice Address - Phone:928-443-5103
Practice Address - Fax:928-443-5104
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-17
Last Update Date:2010-01-13
Deactivation Date:2009-10-28
Deactivation Code:
Reactivation Date:2009-11-20
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZZ123162Medicare PIN