Healthcare Provider Details

I. General information

NPI: 1588568844
Provider Name (Legal Business Name): MIKA HADISH RIDE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/07/2026
Last Update Date: 10/07/2026
Certification Date: 10/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7777 E YALE AVE APT G201
DENVER CO
80231-6078
US

IV. Provider business mailing address

7777 E YALE AVE APT G201
DENVER CO
80231-6078
US

V. Phone/Fax

Practice location:
  • Phone: 720-495-0369
  • Fax:
Mailing address:
  • Phone: 720-495-0369
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License Number
License Number StateNULL

VIII. Authorized Official

Name: KIBROM HADISH
Title or Position: OWNER
Credential:
Phone: 720-495-0369