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General NPI Number Information
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NPI Number | 1801357322
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Entity Type | Individual
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Provider Name | NEGASSE MEBRAHTU
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Gender | Male
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Dates
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Enumeration Date | 03/27/2019
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Last Update Date | 03/27/2019
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Provider Practice Location Address
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Address Line | 17928 E 44TH AVE
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City | DENVER
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State | CO
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Zip | 80249-7611
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Country | US
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Telephone | 720-288-5143
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Fax |
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Provider Business Mailing Address
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Address Line | 1450 S HAVANA ST STE 610
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City | AURORA
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State | CO
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Zip | 80012-4032
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Country | US
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Telephone | 720-288-5143
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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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