Provider Demographics
NPI:1104685270
Name:GREAT VALUES TRANSPORTATION
Entity type:Organization
Organization Name:GREAT VALUES TRANSPORTATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO-OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:CHOLLETA
Authorized Official - Middle Name:WANJIRU
Authorized Official - Last Name:MENJA
Authorized Official - Suffix:
Authorized Official - Credentials:DNP,PMHNP-BC
Authorized Official - Phone:480-232-8260
Mailing Address - Street 1:5723 W PUEBLO AVE
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85043-6404
Mailing Address - Country:US
Mailing Address - Phone:480-678-9426
Mailing Address - Fax:602-225-2201
Practice Address - Street 1:5723 W PUEBLO AVE
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85043-6404
Practice Address - Country:US
Practice Address - Phone:480-678-9426
Practice Address - Fax:602-225-2201
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:GREAT VALUES TRANSPORTATION
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2024-03-18
Last Update Date:2024-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343800000XTransportation ServicesSecured Medical Transport (VAN)