1548331028 NPI number — CRANE MEDICAL TRANSPORTATION CO. LLC

Table of content: (NPI 1548331028)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1548331028 NPI number — CRANE MEDICAL TRANSPORTATION CO. LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
CRANE MEDICAL TRANSPORTATION CO. LLC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1548331028
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
01/12/2014
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 31916
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
TUCSON
Provider Business Mailing Address State Name:
AZ
Provider Business Mailing Address Postal Code:
85751-1916
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
520-885-1733
Provider Business Mailing Address Fax Number:
850-885-1709

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2197 N CAMINO PRINCIPAL
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
TUCSON
Provider Business Practice Location Address State Name:
AZ
Provider Business Practice Location Address Postal Code:
85715-5300
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
520-885-1733
Provider Business Practice Location Address Fax Number:
520-885-1709
Provider Enumeration Date:
11/13/2006

Additional Information

Authorized Official

Authorized Official Last Name:
CRANE
Authorized Official First Name:
PAUL
Authorized Official Middle Name:
C.
Authorized Official Title or Position:
OWNER
Authorized Official Telephone Number:
520-975-4902

Provider Taxonomy Codes

  • Taxonomy code: 343900000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 973489 . This is a "AHCCCS ID#" identifier , issued by the state of ( AZ ) . This identifiers is of the category "OTHER".




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