Wagon Trail Professional Transport Llc

LBN: Wagon Trail Professional Transport Llc
Wagon Trail Professional Transport Llc is an health care organization with primary practice located at 24 Slick Rock Dr , Fort Defiance AZ 86504. The organization recently has only one registered license in Transportation Services / Non-emergency Medical Transport (VAN), which is considered as the primary health care specialty. Wagon Trail Professional Transport Llc can be contacted via phone (928) 729-2944, or through Lowley, Forrest via phone (928) 729-2944.

Contact Information

Primary practice address
24 Slick Rock Dr Fort Defiance AZ 86504
Phone: (928) 729-2944
Fax: (928) 729-2400
Website:
Map and Directions
Authorized official contact:
Name: Lowley, Forrest
Phone: (928) 729-2944

Health care specialties

SpecialtyCodeLicense #State
Transportation Services / Non-emergency Medical Transport (VAN) 343900000X L-1781666-8 Arizona

Profile Details

NPI number 1124455357
LBN Legal business name Wagon Trail Professional Transport Llc
DBA Doing business as
Authorized official Lowley, Forrest
Entity Organization
Organization subpart 1 No
Enumeration date Oct 2nd, 2013
Last updated Oct 2nd, 2013 - about 11 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1124455357 NPPES
Arizona MEDICAID L-1781666-8

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