Provider Demographics
NPI:1629274881
Name:MEDTRANS EXPRESS, INC
Entity type:Organization
Organization Name:MEDTRANS EXPRESS, INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:ABDULLAH
Authorized Official - Middle Name:A
Authorized Official - Last Name:TALIB
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:480-604-8450
Mailing Address - Street 1:432 E SOUTHERN AVE
Mailing Address - Street 2:
Mailing Address - City:TEMPE
Mailing Address - State:AZ
Mailing Address - Zip Code:85282-5216
Mailing Address - Country:US
Mailing Address - Phone:602-324-7178
Mailing Address - Fax:480-461-6670
Practice Address - Street 1:432 E SOUTHERN AVE
Practice Address - Street 2:
Practice Address - City:TEMPE
Practice Address - State:AZ
Practice Address - Zip Code:85282-5216
Practice Address - Country:US
Practice Address - Phone:602-324-7178
Practice Address - Fax:480-461-6670
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-25
Last Update Date:2024-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ379544343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ160823OtherMEDICAL TRANSPORTAION