Organization
SUPREME HEALTH & TRANSPORT SERVICE LLC
Active
Other names
Supreme Medical Transport
Organization subpart
No
Provider details
NPI number
Authorized official
MS. DEBBIE ELAINE OKOJIE (OWNER)
(520) 529-9039
Entity
Organization
Contact information
Practice address
4572 N AVENIDA POLACCA, TUCSON, AZ 85749-9524
(520) 529-9039
Mailing address
PO BOX 32667, TUCSON, AZ 85751-2667
(520) 529-9039
Taxonomy
Speciality
Code
Description
License number
State
343900000X
Non-emergency Medical Transport (VAN)
Primary
—
AZ
385H00000X
Respite Care
—
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
608851
AHCCCS
AZ
Enumeration date
05/26/2011
Last updated
05/26/2011
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