Organization
ROSS N DIA
Active
Organization
ROSS N DIA
Active
Other names
American Native Medical Transport
Organization subpart
No
Provider details
NPI number
Authorized official
ROSS DIA (OWNER)
(602) 284-1321
Entity
Organization
Contact information
Practice address
BONITA DRIVE, FT. DEFIANCE HOSPITAL, FT. DEFIANCE, AZ 86504
(520) 579-8171
(520) 579-3515
Mailing address
6021 W POTRILLO PL, TUCSON, AZ 85743-9669
(520) 579-8171
(520) 579-3515
Taxonomy
Speciality
Code
Description
License number
State
3416L0300X
Land Ambulance
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
464199-01
—
AZ
01
—
AZ0152010
BLUE CROSS BLUE SHEILD
AZ
Enumeration date
01/22/2007
Last updated
10/15/2012
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