MEDICARE: MIGHTY RIDE LLC

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	342000000X	Transportation Network Company

General Provider Information

NPI Number	:	1356197537
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MIGHTY RIDE LLC

Provider Business Mailing Address
First Line	:	9923 E JEWELL AVE APT 202
Second Line	:
City	:	AURORA
State	:	CO
Zip	:	80247-6221
Country	:	US
Telephone Number	:	720-229-9289
Fax Number	:

Provider Business Practice Location Address
First Line	:	9923 E JEWELL AVE APT 202
Second Line	:
City	:	AURORA
State	:	CO
Zip	:	80247-6221
Country	:	US
Telephone Number	:	720-229-9289
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	GHEBREKIDAN KIBROM ABRAHA
Credential	:
Telephone Number	:	720-229-9289

Provider Enumeration Date	:	04/27/2024
Last Update Date	:	04/27/2024

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Directions to “MIGHTY RIDE LLC ” Practice Location

Language	Start Address	Practice Location

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