Provider Demographics
NPI:1548331028
Name:CRANE MEDICAL TRANSPORTATION CO. LLC
Entity type:Organization
Organization Name:CRANE MEDICAL TRANSPORTATION CO. LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:C
Authorized Official - Last Name:CRANE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:520-975-4902
Mailing Address - Street 1:PO BOX 31916
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85751-1916
Mailing Address - Country:US
Mailing Address - Phone:520-885-1733
Mailing Address - Fax:850-885-1709
Practice Address - Street 1:2197 N CAMINO PRINCIPAL
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85715-5300
Practice Address - Country:US
Practice Address - Phone:520-885-1733
Practice Address - Fax:520-885-1709
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-13
Last Update Date:2014-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ973489OtherAHCCCS ID#