MEDICARE: DENVER MED TRANS INC

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	172A00000X	Driver		CO
2	343900000X	Non-emergency Medical Transport (VAN)

General Provider Information

NPI Number	:	1497116925
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DENVER MED TRANS INC

Provider Business Mailing Address
First Line	:	14501 E ATLANTIC DR
Second Line	:
City	:	AURORA
State	:	CO
Zip	:	80014-1513
Country	:	US
Telephone Number	:	720-275-7771
Fax Number	:

Provider Business Practice Location Address
First Line	:	14501 E ATLANTIC DR
Second Line	:
City	:	AURORA
State	:	CO
Zip	:	80014-1513
Country	:	US
Telephone Number	:	720-275-7771
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	ASATUR GASISYAN
Credential	:
Telephone Number	:	720-275-7771

Provider Enumeration Date	:	03/10/2016
Last Update Date	:	04/20/2016

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