Tricare Medical Trans LLC

Primary specialty

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

Legal business name

TRICARE MEDICAL TRANS LLC

Practice address

1825 W Ocotillo Rd
Ste #42
Phoenix, AZ 85015-1257

Phone

(602) 368-7307

Fax

(602) 368-7308

NPI assigned

May 24, 2009

Organization subpart

No

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

Authorized official

Name

Mr. Ali Mahmoud

Title

Owner

Phone

(602) 368-1707

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1243123200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1243123200000",
    "number": "1376778050",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1825 W OCOTILLO RD",
            "address_2": "STE #42",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850151257",
            "telephone_number": "602-368-7307",
            "fax_number": "602-368-7308"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1825 W OCOTILLO RD",
            "address_2": "STE #42",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850151257",
            "telephone_number": "602-368-7307",
            "fax_number": "602-368-7308"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TRICARE MEDICAL TRANS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-05-24",
        "last_updated": "2009-05-24",
        "status": "A",
        "authorized_official_last_name": "MAHMOUD",
        "authorized_official_first_name": "ALI",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "602-368-1707",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "343900000X",
            "taxonomy_group": "",
            "desc": "Non-emergency Medical Transport (VAN)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0096611101",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Non-emergency Medical Transport (VAN) in Phoenix, AZ
• Providers in Phoenix, 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 24, 2009; 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.