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General NPI Number Information
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NPI Number | 1992152334
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Entity Type | Organization
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Legal Business Name | TEDDY LIMOUSINE LLC
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Dates
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Enumeration Date | 05/16/2016
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Last Update Date | 05/16/2016
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Provider Practice Location Address
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Address Line | 8680 E ALAMEDA AVE APT 1113
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City | DENVER
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State | CO
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Zip | 80247-1108
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Country | US
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Telephone | 303-875-7459
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Fax |
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Provider Business Mailing Address
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Address Line | 8680 E ALAMEDA AVE APT 1113
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City | DENVER
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State | CO
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Zip | 80247-1108
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Country | US
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Telephone | 303-875-7459
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | TTEWODROS KOKEB ENGDAYEHU
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Credential |
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Telephone | 303-875-7459
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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 | B-10055
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License Number State | CO
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