Tabaaha Transport LLC

Primary specialty

Non-emergency Medical Transport (VAN)Taxonomy code 343900000X

Legal business name

TABAAHA TRANSPORT LLC

Practice address

101 Pine Hill Blvd
Rio Puerco Hse
Fort Defiance, AZ 86504

Phone

(928) 551-1463

NPI assigned

May 15, 2014

Last updated

May 15, 2014By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Simone Renee Smith

Title

Owner

Phone

(928) 551-1463

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1400112000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1400112000000",
    "number": "1316358096",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 644",
            "city": "FORT DEFIANCE",
            "state": "AZ",
            "postal_code": "865040644",
            "telephone_number": "928-551-1463"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 PINE HILL BLVD",
            "address_2": "RIO PUERCO HSE",
            "city": "FORT DEFIANCE",
            "state": "AZ",
            "postal_code": "86504",
            "telephone_number": "928-551-1463"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TABAAHA TRANSPORT LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-05-15",
        "last_updated": "2014-05-15",
        "status": "A",
        "authorized_official_last_name": "SMITH",
        "authorized_official_first_name": "SIMONE",
        "authorized_official_middle_name": "RENEE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "928-551-1463"
    },
    "taxonomies": [
        {
            "code": "343900000X",
            "taxonomy_group": "",
            "desc": "Non-emergency Medical Transport (VAN)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Courtney Cathleen Steer-Massaro, C.N.M., F.N.P.-C.
• Emily Caroline Stipe
• Carol McConnell Stout, CNM
• Tyler Ann Sutherland, MA
• Ian Thomas Swensen, PA-C
• Laura Tape, RCP
• Melissa L Taylor, RN
• Dale Tennyson, RN
• The Fort Defiance Indian Hospital Board, Incorporation (Fort Defiance Indian Hospital)
• The Fort Defiance Indian Hospital Board, Incorporation (Fort Defiance Indian Hospital)

• Non-emergency Medical Transport (VAN) in Fort Defiance, AZ
• Providers in Fort Defiance, AZ by specialty
• Non-emergency Medical Transport (VAN) in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 15, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.