Organization
STATEWIDE EXPRESS INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
AMY JOLENE WESTWOOD (OFFICE MANAGER)
(928) 453-6112
Entity
Organization
Contact information
Practice address
551 MARINA BLVD, BULLHEAD CITY, AZ 86442-5413
(928) 758-5455
(928) 453-5119
Mailing address
3417 MARICOPA AVE, LAKE HAVASU CITY, AZ 86406-9197
(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
02/04/2009
Last updated
02/04/2009
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