Provider Demographics
NPI:1386880730
Name:BUBBA'S TRANSPORTATION
Entity type:Organization
Organization Name:BUBBA'S TRANSPORTATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT & SEC
Authorized Official - Prefix:MRS
Authorized Official - First Name:DONNA
Authorized Official - Middle Name:MARIA
Authorized Official - Last Name:ALLMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:480-228-5226
Mailing Address - Street 1:867 E MOUNTAIN VIEW RD
Mailing Address - Street 2:
Mailing Address - City:QUEEN CREEK
Mailing Address - State:AZ
Mailing Address - Zip Code:85243-5328
Mailing Address - Country:US
Mailing Address - Phone:480-228-5226
Mailing Address - Fax:413-683-9068
Practice Address - Street 1:867 E MOUNTAIN VIEW RD
Practice Address - Street 2:
Practice Address - City:QUEEN CREEK
Practice Address - State:AZ
Practice Address - Zip Code:85243-5328
Practice Address - Country:US
Practice Address - Phone:480-228-5226
Practice Address - Fax:413-683-9068
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-01-06
Last Update Date:2009-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZBMF#: 32623343900000X, 344600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes344600000XTransportation ServicesTaxi
No343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ388671OtherAHCCCS