Healthcare Provider Details

I. General information

NPI: 1063316313
Provider Name (Legal Business Name): NUBIAN TRANSPORTATION 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

817 5TH ST
GREELEY CO
80631-2318
US

IV. Provider business mailing address

817 5TH ST
GREELEY CO
80631-2318
US

V. Phone/Fax

Practice location:
  • Phone: 970-388-1487
  • Fax:
Mailing address:
  • Phone: 970-388-1487
  • 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: SABA TSEGAY
Title or Position: MANAGER
Credential:
Phone: 970-388-1487