SACRED MOUNTAIN MEDICAL SERVICE NPI 1871739755

NPI Information

NPI: 1871739755
Provider Name: SACRED MOUNTAIN MEDICAL SERVICE
Classification: Ambulance - 3416L0300X
Entity Type: Organization

Specialization: Land Transport

Address:
100 MOENAVE ROAD
#39
TUBA CITY, AZ
ZIP 86045
Phone: (928) 283-8243
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SACRED MOUNTAIN MEDICAL SERVICE is a land transport ambulance in Tuba City, AZ. SACRED MOUNTAIN MEDICAL SERVICE NPI is 1871739755. The provider is registered as an organization entity type.

The provider's business location address is:

100 MOENAVE ROAD
#39
TUBA CITY, AZ
ZIP 86045
Phone: (928) 283-8243
Fax: (928) 283-8237

The provider's authorized official is Danny Barney .
The authorized official title is Ceo and has the following contact phone number (928) 283-8243.

The enumeration date for this NPI number is 12/26/2008 and was last updated on 12/26/2008.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	3416L0300X	Ambulance	Land Transport	127	ARIZONA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	830384848001	MEDICAID	UTAH
2	P00084177	MEDICARE PIN
3	AZ0152480	OTHER	ARIZONA	BLUE CROSS BLUE SHIELD
4	40953866	MEDICAID	NEW MEXICO
5	02876271	MEDICAID	MISSISSIPPI
6	XMTEO6557	MEDICAID	CALIFORNIA
7	717077	MEDICAID	ARIZONA
8	Z77633	MEDICARE PIN	ARIZONA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

NPI Synchronization or Removal

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