Organization
CHICAGO MEDICAL TRANSPORTATION
Active
Organization
CHICAGO MEDICAL TRANSPORTATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
AHMED A KHAIRALLA (OWENER)
(480) 232-1935
Entity
Organization
Contact information
Practice address
1753 E BROADWAY RD, STE 101 #309, TEMPE, AZ 85282-2081
(480) 232-1935
Mailing address
1753 E BROADWAY RD, STE 101 #309, TEMPE, AZ 85282-2081
(480) 232-1935
Taxonomy
Speciality
Code
Description
License number
State
343900000X
Non-emergency Medical Transport (VAN)
Primary
454836
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
454836
—
AZ
Enumeration date
09/13/2009
Last updated
09/13/2009
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