Healthcare Provider Details

I. General information

NPI: 1902729718
Provider Name (Legal Business Name): BRONCOS RIDS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/30/2026
Last Update Date: 07/30/2026
Certification Date: 07/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9958 E LOUISIANA DR APT 6-204
AURORA CO
80247-2395
US

IV. Provider business mailing address

9958 E LOUISIANA DR APT 6-204
AURORA CO
80247-2395
US

V. Phone/Fax

Practice location:
  • Phone: 720-257-3399
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code343800000X
TaxonomySecured Medical Transport (VAN)
License Number
License Number State

VIII. Authorized Official

Name: ROBEL YOHANNES
Title or Position: MANAGER
Credential:
Phone: 720-257-3391