Sacred Mountain Non-Medical Transport

Primary specialty

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

Legal business name

SACRED MOUNTAIN NON-MEDICAL TRANSPORT

Practice address

Hwy 264 RT 12 Space 4
Windowrock, AZ 86515

Phone

(928) 871-4997

Fax

(928) 871-5008

NPI assigned

Feb 10, 2010

Last updated

Feb 10, 2010By 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

Mr. Tony D. Lilly

Title

Owner

Phone

(928) 871-4997

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1265760000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1265760000000",
    "number": "1811229214",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 315",
            "city": "ST MICHAELS",
            "state": "AZ",
            "postal_code": "865110315",
            "telephone_number": "928-871-4997",
            "fax_number": "928-871-5008"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "HWY 264 RT 12 SPACE 4",
            "city": "WINDOWROCK",
            "state": "AZ",
            "postal_code": "86515",
            "telephone_number": "928-871-4997",
            "fax_number": "928-871-5008"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SACRED MOUNTAIN NON-MEDICAL TRANSPORT",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-02-10",
        "last_updated": "2010-02-10",
        "status": "A",
        "authorized_official_last_name": "LILLY",
        "authorized_official_first_name": "TONY",
        "authorized_official_middle_name": "D.",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "928-871-4997",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "343900000X",
            "taxonomy_group": "",
            "desc": "Non-emergency Medical Transport (VAN)",
            "state": "AZ",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Non-emergency Medical Transport (VAN) in Window Rock, AZ
• Providers in Window Rock, 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 Feb 10, 2010; 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.