Provider Demographics
NPI:1912420621
Name:SAFE RUN NON EMERGENCY MEDICAL TRANSPORTATION LLC
Entity type:Organization
Organization Name:SAFE RUN NON EMERGENCY MEDICAL TRANSPORTATION LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:TAMARA
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:JACKSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:623-703-0570
Mailing Address - Street 1:7205 W MCDOWELL RD APT 1073
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85035-4551
Mailing Address - Country:US
Mailing Address - Phone:623-241-7101
Mailing Address - Fax:
Practice Address - Street 1:7205 W MCDOWELL RD
Practice Address - Street 2:APT 1073
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85035
Practice Address - Country:US
Practice Address - Phone:623-241-7101
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-07-25
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZL21049507343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)