Healthcare Provider Details

I. General information

NPI: 1225932296
Provider Name (Legal Business Name): GOOD HEART TRANSPORTATION LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/05/2026
Last Update Date: 10/05/2026
Certification Date: 10/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

821 28TH AVE
GREELEY CO
80634-5835
US

IV. Provider business mailing address

821 28TH AVE
GREELEY CO
80634-5835
US

V. Phone/Fax

Practice location:
  • Phone: 317-361-6130
  • Fax:
Mailing address:
  • Phone: 317-361-6130
  • 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: SANAULLAH ABDUR RAHIM
Title or Position: CEO
Credential:
Phone: 317-361-6130