Healthcare Provider Details

I. General information

NPI: 1457719692
Provider Name (Legal Business Name): GOLDEN MEDICAL TRANSPORTATION SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/02/2016
Last Update Date: 09/24/2021
Certification Date: 09/24/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1450 S HAVANA ST STE 232
AURORA CO
80012-4021
US

IV. Provider business mailing address

1450 S HAVANA ST STE 232
AURORA CO
80012-4021
US

V. Phone/Fax

Practice location:
  • Phone: 720-404-5377
  • Fax: 303-693-6553
Mailing address:
  • Phone: 720-404-5377
  • Fax: 303-693-6553

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251C00000X
TaxonomyDevelopmentally Disabled Services Day Training Agency
License Number22405364
License Number StateCO
# 2
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number22405364
License Number StateCO
# 3
Primary TaxonomyN
Taxonomy Code261QD1600X
TaxonomyDevelopmental Disabilities Clinic/Center
License Number22405364
License Number StateCO
# 4
Primary TaxonomyN
Taxonomy Code320900000X
TaxonomyIntellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License NumberB-09970
License Number StateCO
# 6
Primary TaxonomyN
Taxonomy Code376J00000X
TaxonomyHomemaker
License Number
License Number State
# 7
Primary TaxonomyN
Taxonomy Code385HR2065X
TaxonomyChild Physical Disabilities Respite Care
License Number22405364
License Number StateCO

VIII. Authorized Official

Name: MR. CHUKS IDIKA
Title or Position: MANAGING DIRECTOR
Credential: MD
Phone: 720-404-5377