Organization Name: | STATEWIDE EXPRESS |
NPI Number: | 1659319390 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | AMY JOLENE WESTWOOD (BILLING MANAGER) |
Mailing Address: | 3417 Maricopa Ave Lake Havasu City |
State: | AZ US |
Postal Code: | 864069041 |
Phone Number: | 9286801222 |
Fax Number: | 9286803680 |
NPI Enumeration Date: | 06/03/2006 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 343900000X |
License Number: | 0700004870 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | AZ |
Taxonomy Type: | Transportation Services |
Taxonomy Classification: | Non-emergency Medical Transport (VAN) |
Taxonomy Specialization: | |
Taxonomy Definition: | A land vehicle with a capacity to meet special height, clearance, access, and seating, for the conveyance of persons in non-emergency situations. The vehicle may or may not be required to meet local county or state regulations. |