MEDICARE: BINALFEW MENGISTU

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	163WH0200X	Home Health Registered Nurse	04J235	CO

General Provider Information

NPI Number	:	1417561184
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BINALFEW MENGISTU

Provider Business Mailing Address
First Line	:	2250 S NOME CT
Second Line	:
City	:	AURORA
State	:	CO
Zip	:	80014
Country	:	US
Telephone Number	:	720-277-4012
Fax Number	:	303-731-4681

Provider Business Practice Location Address
First Line	:	2250 S NOME CT
Second Line	:
City	:	AURORA
State	:	CO
Zip	:	80014-8001
Country	:	US
Telephone Number	:	720-277-4012
Fax Number	:

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

Provider Enumeration Date	:	09/01/2020
Last Update Date	:	09/01/2020

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Directions to “ BINALFEW MENGISTU ” Practice Location

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