Provider Demographics
NPI:1285919209
Name:CRANE MEDICAL TRANSPORTATION
Entity type:Organization
Organization Name:CRANE MEDICAL TRANSPORTATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:GENERAL MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:
Authorized Official - Last Name:HERNANDEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:520-975-2339
Mailing Address - Street 1:2197 N CAMINO PRINCIPAL
Mailing Address - Street 2:STE #148
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85715-5300
Mailing Address - Country:US
Mailing Address - Phone:520-885-1733
Mailing Address - Fax:
Practice Address - Street 1:2197 N CAMINO PRINCIPAL
Practice Address - Street 2:STE #148
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85715-5300
Practice Address - Country:US
Practice Address - Phone:520-885-1733
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-10-21
Last Update Date:2011-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ1149041343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)