Organization Name: | BUENA SUERTE, INC. |
NPI Number: | 1003128349 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | CHRISTOPHER L GAMBLE (PRESIDENT) |
Mailing Address: | 387 Lake Havasu Ave S Suite 102 Lake Havasu City |
State: | AZ US |
Postal Code: | 864039306 |
Phone Number: | 9288550005 |
Fax Number: | 9288550075 |
NPI Enumeration Date: | 07/01/2010 |
NPI Last Update Date: | 04/30/2011 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 347C00000X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | AZ |
Taxonomy Type: | Transportation Services |
Taxonomy Classification: | Private Vehicle |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual paid to provide non-emergency transportation using their privately owned/leased vehicle. |