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SACRED MOUNTAIN MEDICAL SERVICES INC

Land Transport

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Contact Information

SACRED MOUNTAIN MEDICAL SERVICES INC
NP-39 MOENAVE RD/LOLMA ST
TUBA CITY, AZ  86045
 Phone: 928-283-8243
 Fax: 928-283-8237
 Website:
 

Specialty

 Taxonomy Code Specialty Code Provider Type

Land Transport

 3416L0300X 59 Ambulance Service Provider
Indicates primary specialty

NPI Profile & details for SACRED MOUNTAIN MEDICAL SERVICES INC

NPI # 1447288436
LBN Legal business name SACRED MOUNTAIN MEDICAL SERVICES INC
Authorized official DANNY BARNEY - (OWNER)
Entity Organization
Organization subpart 1 No
Enumeration date 06/29/2006
Last updated 12/22/2008 - About 17 years ago
Identifiers
AZ License # 127
AZ Medicaid 717077
CA Medicaid XMTE06557
MS Medicaid 02876271
NM Medicaid 40953866
AZ Other AZ0152480 BLUE CROSS BLUE SHIELD
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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