1215108279 NPI number — TOUR TRANS LLC

Table of content: (NPI 1215108279)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1215108279 NPI number — TOUR TRANS LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
TOUR 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:
1215108279
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
03/18/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
3821 S EUCALYPTUS PL
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
CHANDLER
Provider Business Mailing Address State Name:
AZ
Provider Business Mailing Address Postal Code:
85286-2776
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
602-348-3294
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
3821 S EUCALYPTUS PL
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
CHANDLER
Provider Business Practice Location Address State Name:
AZ
Provider Business Practice Location Address Postal Code:
85286-2776
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
602-348-3294
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
03/18/2008

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
MOHAMED
Authorized Official First Name:
ADEN
Authorized Official Middle Name:
HASSAN
Authorized Official Title or Position:
OWNER
Authorized Official Telephone Number:
602-348-3294

Provider Taxonomy Codes

  • Taxonomy code: 343900000X , with the licence number:  263621 , 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)

  • Identifier: 263621 . This is a "MEDICL TRANSPORTATION" identifier , issued by the state of ( AZ ) . This identifiers is of the category "OTHER".