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General NPI Number Information
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NPI Number | 1538688999
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Entity Type | Organization
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Legal Business Name | OWNER
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Dates
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Enumeration Date | 09/15/2017
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Last Update Date | 09/15/2017
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Provider Practice Location Address
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Address Line | 5421 ODESSA ST
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City | DENVER
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State | CO
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Zip | 80249-8393
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Country | US
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Telephone | 720-612-0815
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Fax |
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Provider Business Mailing Address
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Address Line | 14179 E KENTUCKY PL APT 102
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City | AURORA
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State | CO
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Zip | 80012-3665
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Country | US
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Telephone | 720-612-0815
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | ESKINDER WELDEGIORGIS
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Credential |
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Telephone | 720-612-0815
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 343900000X
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Taxonomy Name | Non-emergency Medical Transport (VAN)
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License Number |
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License Number State |
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