Provider Demographics
NPI:1932737798
Name:5 STAR MED TRANS
Entity Type:Organization
Organization Name:5 STAR MED TRANS
Other - Org Name:CEO
Other - Org Type:Doing Business As
Authorized Official - Title/Position:A
Authorized Official - Prefix:
Authorized Official - First Name:MARYAN
Authorized Official - Middle Name:A
Authorized Official - Last Name:HASHI
Authorized Official - Suffix:
Authorized Official - Credentials:M H
Authorized Official - Phone:505-414-7976
Mailing Address - Street 1:213 W MESA AVE # 3100
Mailing Address - Street 2:
Mailing Address - City:GALLUP
Mailing Address - State:NM
Mailing Address - Zip Code:87301-6335
Mailing Address - Country:US
Mailing Address - Phone:505-435-0676
Mailing Address - Fax:
Practice Address - Street 1:501 S 48TH ST STE 114
Practice Address - Street 2:
Practice Address - City:TEMPE
Practice Address - State:AZ
Practice Address - Zip Code:85281-2313
Practice Address - Country:US
Practice Address - Phone:505-435-0676
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-03-28
Last Update Date:2020-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)