Healthcare Provider Details

I. General information

NPI: 1487505137
Provider Name (Legal Business Name): MAWERDI ALI MAHAMUD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/09/2026
Last Update Date: 03/29/2026
Certification Date: 03/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1808 28TH AVE
GREELEY CO
80634-5717
US

IV. Provider business mailing address

1808 28TH AVE
GREELEY CO
80634-5717
US

V. Phone/Fax

Practice location:
  • Phone: 719-895-0499
  • Fax:
Mailing address:
  • Phone: 718-895-0499
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: