Provider Demographics
NPI:1306996848
Name:COMTRANS
Entity type:Organization
Organization Name:COMTRANS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF FINANCIAL OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:JILL
Authorized Official - Middle Name:
Authorized Official - Last Name:GILLESPIE
Authorized Official - Suffix:
Authorized Official - Credentials:CPA
Authorized Official - Phone:602-231-0102
Mailing Address - Street 1:2336 E MAGNOLIA ST
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85034-6819
Mailing Address - Country:US
Mailing Address - Phone:602-231-0102
Mailing Address - Fax:602-231-0015
Practice Address - Street 1:2336 E MAGNOLIA ST
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85034-6819
Practice Address - Country:US
Practice Address - Phone:602-231-0102
Practice Address - Fax:602-231-0015
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-10
Last Update Date:2010-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ515025OtherAHCCCS ID NUMBER