Organization
STATEWIDE EXPRESS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
AMY JOLENE WESTWOOD (BILLING MANAGER)
(928) 680-1222
Entity
Organization
Contact information
Practice address
3417 MARICOPA AVE, LAKE HAVASU CITY, AZ 86406-9041
(928) 680-1222
(928) 680-3680
Mailing address
3417 MARICOPA AVE, LAKE HAVASU CITY, AZ 86406-9041
(928) 680-1222
(928) 680-3680
Taxonomy
Speciality
Code
Description
License number
State
343900000X
Non-emergency Medical Transport (VAN)
Primary
0700004870
AZ
Other
Enumeration date
06/03/2006
Last updated
08/22/2020
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