Provider Demographics
NPI:1568283703
Name:SAGUARO MEDICAL TRANSPORT
Entity type:Organization
Organization Name:SAGUARO MEDICAL TRANSPORT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SHAUN
Authorized Official - Middle Name:
Authorized Official - Last Name:BLUTH
Authorized Official - Suffix:
Authorized Official - Credentials:RN, BSN
Authorized Official - Phone:480-294-8836
Mailing Address - Street 1:1275 N CONNER AVE
Mailing Address - Street 2:
Mailing Address - City:GILBERT
Mailing Address - State:AZ
Mailing Address - Zip Code:85234-0226
Mailing Address - Country:US
Mailing Address - Phone:480-294-8836
Mailing Address - Fax:
Practice Address - Street 1:6400 E GRANT RD STE 130
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85715-3917
Practice Address - Country:US
Practice Address - Phone:520-540-0326
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-10-21
Last Update Date:2024-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)