Organization
ASSIST TO INDEPENDENCE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. LORRAINE JONES NOLINE (EXECUTIVE DIRECTOR)
(928) 283-6290
Entity
Organization
Contact information
Practice address
EAST CEDAR AVENUE, SE TUBA CITY INDIAN MEDICAL CENTER LOT, TUBA CITY, AZ 86045-4133
(928) 283-6261
(928) 283-6284
Mailing address
PO BOX 4133, TUBA CITY, AZ 86045-4133
(928) 283-6261
(928) 283-6284
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
03-028432Z
AZ
332BC3200X
Customized Equipment (DME)
459512
AZ
343900000X
Non-emergency Medical Transport (VAN)
Primary
457730
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
457730
—
AZ
05
—
459512
—
AZ
05
—
775059
—
AZ
Enumeration date
01/25/2006
Last updated
03/26/2014
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