MEDICARE: TESFA DAREBO

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	343900000X	Non-emergency Medical Transport (VAN)		CO

General Provider Information

NPI Number	:	1265218846
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TESFA DAREBO

Provider Business Mailing Address
First Line	:	4507 ESPANA WAY
Second Line	:
City	:	DENVER
State	:	CO
Zip	:	80249-6651
Country	:	US
Telephone Number	:	720-589-9347
Fax Number	:

Provider Business Practice Location Address
First Line	:	4507 ESPANA WAY
Second Line	:
City	:	DENVER
State	:	CO
Zip	:	80249-6651
Country	:	US
Telephone Number	:	720-589-9347
Fax Number	:

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

Provider Enumeration Date	:	09/07/2023
Last Update Date	:	09/13/2024

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Directions to “ TESFA DAREBO ” Practice Location

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