Provider Demographics
NPI:1952550824
Name:BLUE NILE TRANS LLC
Entity Type:Organization
Organization Name:BLUE NILE TRANS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:ELTAHIR
Authorized Official - Middle Name:ABDELA
Authorized Official - Last Name:GALGAL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:602-314-0309
Mailing Address - Street 1:8901 N 35TH AVE
Mailing Address - Street 2:# 167
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85051-3845
Mailing Address - Country:US
Mailing Address - Phone:602-314-0309
Mailing Address - Fax:602-864-3415
Practice Address - Street 1:8901 N 35TH AVE
Practice Address - Street 2:# 167
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85051-3845
Practice Address - Country:US
Practice Address - Phone:602-314-0309
Practice Address - Fax:602-864-3415
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-09-16
Last Update Date:2008-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)