Healthcare Provider Details

I. General information

NPI: 1295195113
Provider Name (Legal Business Name): ST.ARSEMA TRANSPORTATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/04/2016
Last Update Date: 11/18/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1039 S PARKER RD
DENVER CO
80231-2532
US

IV. Provider business mailing address

1039 S PARKER RD
DENVER CO
80231-2532
US

V. Phone/Fax

Practice location:
  • Phone: 720-338-1364
  • 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 Code344600000X
TaxonomyTaxi
License Number2011 -BFN-1056909
License Number StateCO
# 3
Primary TaxonomyN
Taxonomy Code344600000X
TaxonomyTaxi
License Number2011-BFN-1056909
License Number StateCO

VIII. Authorized Official

Name: BERHANE KIDANE HAGOS
Title or Position: DRIVER
Credential:
Phone: 720-338-1364