Provider Demographics
NPI:1962840629
Name:3TURKEY INGENUITY, LLC
Entity type:Organization
Organization Name:3TURKEY INGENUITY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:RASHAWN
Authorized Official - Middle Name:LEE
Authorized Official - Last Name:IZZO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:928-674-5204
Mailing Address - Street 1:PO BOX 3994
Mailing Address - Street 2:
Mailing Address - City:CHINLE
Mailing Address - State:AZ
Mailing Address - Zip Code:86503-3994
Mailing Address - Country:US
Mailing Address - Phone:928-674-5204
Mailing Address - Fax:
Practice Address - Street 1:NAVAJO RTE 7
Practice Address - Street 2:CKC 12
Practice Address - City:CHINLE
Practice Address - State:AZ
Practice Address - Zip Code:86503-3994
Practice Address - Country:US
Practice Address - Phone:928-674-5204
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-06-04
Last Update Date:2013-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)