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NPI Code Detail

MEDICARE: HISGRACE TRANSIT LLC

MEDICARE: HISGRACE TRANSIT LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1343900000XNon-emergency Medical Transport (VAN)

General Provider Information

NPI Number : 1831861251
Entity Type Code : Organization
Provider Name (Legal Business Name) : HISGRACE TRANSIT LLC
Provider Business Mailing Address
First Line : 6401 BROADWAY UNIT K
Second Line :
City : DENVER
State : CO
Zip : 80221-2853
Country : US
Telephone Number : 405-778-0712
Fax Number :
Provider Business Practice Location Address
First Line : 6401 BROADWAY STE K
Second Line :
City : DENVER
State : CO
Zip : 80221-2853
Country : US
Telephone Number : 405-778-0712
Fax Number :
Authorized Official
Title or Position : CEO
Name : MR. GERALD CHUKWUDI AMALAHA
Credential :
Telephone Number : 405-778-0712
Provider Enumeration Date : 10/04/2021
Last Update Date : 11/24/2021

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Directions to “HISGRACE TRANSIT LLC ” Practice Location

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