Organization
PROUDLY ARIZONA LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ESRA A KHALEEL MS (OWNER/MANAGER)
(323) 378-8797
Entity
Organization
Contact information
Practice address
1717 W NORTHERN AVE STE 106, PHOENIX, AZ 85021-5400
(323) 378-8797
Mailing address
4816 W BETHANY HOME RD APT 90, GLENDALE, AZ 85301-5233
(323) 378-8797
Taxonomy
Speciality
Code
Description
License number
State
342000000X
Transportation Network Company
—
—
343900000X
Non-emergency Medical Transport (VAN)
Primary
—
—
Other
Enumeration date
09/13/2022
Last updated
09/13/2022
Update your record
If you believe information in your NPPES record is inaccurate, or if you wish to update or deactivate your NPI, you can do so directly with CMS at https://nppes.cms.hhs.gov.
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Sign up