Organization
TABAAHA TRANSPORT LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SIMONE RENEE SMITH (OWNER)
(928) 551-1463
Entity
Organization
Contact information
Practice address
101 PINE HILL BLVD, RIO PUERCO HSE, FORT DEFIANCE, AZ 86504
(928) 551-1463
Mailing address
PO BOX 644, FORT DEFIANCE, AZ 86504-0644
(928) 551-1463
Taxonomy
Speciality
Code
Description
License number
State
343900000X
Non-emergency Medical Transport (VAN)
Primary
—
—
Other
Enumeration date
05/15/2014
Last updated
05/15/2014
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