1679887079 NPI number — APACHE MED TRANS LLC

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1679887079 NPI number — APACHE MED TRANS LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
APACHE MED TRANS 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:
1679887079
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
11/18/2011
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 26785
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
OVERLAND PARK
Provider Business Mailing Address State Name:
KS
Provider Business Mailing Address Postal Code:
66225-6785
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
913-663-5535
Provider Business Mailing Address Fax Number:
913-663-1503

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
60 E. RIO SALADO PARKWAY
Provider Second Line Business Practice Location Address:
SUITE 900
Provider Business Practice Location Address City Name:
TEMPE
Provider Business Practice Location Address State Name:
AZ
Provider Business Practice Location Address Postal Code:
85281
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
913-663-5535
Provider Business Practice Location Address Fax Number:
913-663-1503
Provider Enumeration Date:
07/28/2010

Additional Information

Authorized Official

Authorized Official Last Name:
CARLSON
Authorized Official First Name:
DAVID
Authorized Official Middle Name:
CARL
Authorized Official Title or Position:
VICE PRESIDENT
Authorized Official Telephone Number:
913-663-5535

Provider Taxonomy Codes

  • Taxonomy code: 3416A0800X , registered in the state of AZ ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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