Healthcare Provider Details

I. General information

NPI: 1639898240
Provider Name (Legal Business Name): MYMO QUALITY TRANSPORT
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/25/2022
Last Update Date: 09/02/2022
Certification Date: 09/02/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

21699 E QUINCY AVE UNIT F-141
AURORA CO
80015-2886
US

IV. Provider business mailing address

21699 E QUINCY AVE UNIT F-141
AURORA CO
80015-2886
US

V. Phone/Fax

Practice location:
  • Phone: 720-696-6690
  • Fax: 720-367-5155
Mailing address:
  • Phone: 720-696-6690
  • Fax: 720-367-5155

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code342000000X
TaxonomyTransportation Network Company
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code347C00000X
TaxonomyPrivate Vehicle
License Number
License Number State

VIII. Authorized Official

Name: MYRON DAWSON JR.
Title or Position: OWNER
Credential:
Phone: 303-696-6690