Provider Demographics
NPI:1629882139
Name:ALEMU, KONSIL TEFERA
Entity type:Individual
Prefix:
First Name:KONSIL
Middle Name:TEFERA
Last Name:ALEMU
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8844 W CORDES RD
Mailing Address - Street 2:
Mailing Address - City:TOLLESON
Mailing Address - State:AZ
Mailing Address - Zip Code:85353-8608
Mailing Address - Country:US
Mailing Address - Phone:602-642-2783
Mailing Address - Fax:
Practice Address - Street 1:8844 W CORDES RD
Practice Address - Street 2:
Practice Address - City:TOLLESON
Practice Address - State:AZ
Practice Address - Zip Code:85353-8608
Practice Address - Country:US
Practice Address - Phone:602-642-2783
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-02-04
Last Update Date:2025-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)