Organization
TARA TRANS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GALALELDIN EISSA OMAR (CEO)
(480) 228-4098
Entity
Organization
Contact information
Practice address
8237 E MCDONALD DR, SCOTTSDALE, AZ 85250-6217
(480) 228-4098
Mailing address
8237 E MCDONALD DR, SCOTTSDALE, AZ 85250-6217
(480) 228-4098
(480) 323-2374
Taxonomy
Speciality
Code
Description
License number
State
343900000X
Non-emergency Medical Transport (VAN)
Primary
L17496308
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
703516
INDIAN HEALTH SERVICE (IHS)
AZ
05
—
703516
—
AZ
Enumeration date
08/16/2012
Last updated
08/16/2012
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