Provider Demographics
NPI:1124271838
Name:CENTRAL ARIZONA TRANSPORT AND SHUTTLE 'LLC'
Entity type:Organization
Organization Name:CENTRAL ARIZONA TRANSPORT AND SHUTTLE 'LLC'
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:ANDREW
Authorized Official - Middle Name:CHRIS
Authorized Official - Last Name:ACOSTA
Authorized Official - Suffix:
Authorized Official - Credentials:TRANSPORT SERVICE
Authorized Official - Phone:520-426-1914
Mailing Address - Street 1:1525 N GILBERT AVE
Mailing Address - Street 2:
Mailing Address - City:CASA GRANDE
Mailing Address - State:AZ
Mailing Address - Zip Code:85222-2704
Mailing Address - Country:US
Mailing Address - Phone:520-426-1914
Mailing Address - Fax:520-426-1759
Practice Address - Street 1:1525 N GILBERT AVE
Practice Address - Street 2:
Practice Address - City:CASA GRANDE
Practice Address - State:AZ
Practice Address - Zip Code:85222-2704
Practice Address - Country:US
Practice Address - Phone:520-426-1914
Practice Address - Fax:520-426-1759
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-10-25
Last Update Date:2008-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ0808456343900000X, 344600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes344600000XTransportation ServicesTaxi
No343900000XTransportation ServicesNon-emergency Medical Transport (VAN)