MEDICARE: MR. ARJIM AUTO EMT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	146N00000X	Basic Emergency Medical Technician	E1841787	CO

General Provider Information

NPI Number	:	1225395072
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. ARJIM AUTO EMT

Provider Business Mailing Address
First Line	:	2276 BLUE FESCUE CT
Second Line	:
City	:	COLORADO SPRINGS
State	:	CO
Zip	:	80915-2034
Country	:	US
Telephone Number	:	719-258-0093
Fax Number	:

Provider Business Practice Location Address
First Line	:	2276 BLUE FESCUE CT
Second Line	:
City	:	COLORADO SPRINGS
State	:	CO
Zip	:	80915-2034
Country	:	US
Telephone Number	:	719-258-0093
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/18/2012
Last Update Date	:	12/18/2023

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