Healthcare Provider Details

I. General information

NPI: 1134826076
Provider Name (Legal Business Name): CEECCIL QUALITY CARE TRANSPORTATION LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/10/2023
Last Update Date: 06/25/2023
Certification Date: 06/25/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2720 E YAMPA ST SUITE 2A
COLORADO SPRINGS CO
80909-5061
US

IV. Provider business mailing address

2620 S PARKER RD STE 205
AURORA CO
80014-1608
US

V. Phone/Fax

Practice location:
  • Phone: 720-669-0696
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code347E00000X
TaxonomyTransportation Broker
License Number
License Number State

VIII. Authorized Official

Name: MOHAMED SALAH BUSHRA OSMAN
Title or Position: BUSINESS OWNER
Credential:
Phone: 720-669-0696