Provider Demographics
NPI:1285883603
Name:VALLEY TRANSPORTATION LLC
Entity type:Organization
Organization Name:VALLEY TRANSPORTATION LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:BOUBA
Authorized Official - Middle Name:LAWAN
Authorized Official - Last Name:HAMADOU
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:520-572-9794
Mailing Address - Street 1:901 S 6TH AVE
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85701-3070
Mailing Address - Country:US
Mailing Address - Phone:520-572-9794
Mailing Address - Fax:520-572-4330
Practice Address - Street 1:901 S 6TH AVE
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85701-3070
Practice Address - Country:US
Practice Address - Phone:520-572-9794
Practice Address - Fax:520-572-4330
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-09-09
Last Update Date:2008-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ3002813343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ314465OtherAHCCS