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General NPI Number Information
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NPI Number | 1801588710
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Entity Type | Organization
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Legal Business Name | SUPREME LIMO LLC
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Dates
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Enumeration Date | 05/22/2023
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Last Update Date | 05/25/2023
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Provider Practice Location Address
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Address Line | 1710 BRIARGATE BLVD STE 456
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City | COLORADO SPRINGS
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State | CO
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Zip | 80920-3462
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Country | US
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Telephone | 303-669-6795
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Fax |
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Provider Business Mailing Address
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Address Line | 1560 S FAIRPLAY WAY
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City | AURORA
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State | CO
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Zip | 80012-5725
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Country | US
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Telephone | 303-669-6795
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Fax |
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Authorized Official
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Title or Position | OWNER/MANAGER
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Name | YOSEF SEYOUM
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Credential |
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Telephone | 303-669-6795
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 342000000X
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Taxonomy Name | Transportation Network Company
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 347E00000X
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Taxonomy Name | Transportation Broker
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License Number |
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License Number State |
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Taxonomy #3
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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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