MEDICARE: COLORADO SPIRIT TRANSPORTATION, 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	343900000X	Non-emergency Medical Transport (VAN)

General Provider Information

NPI Number	:	1659513984
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	COLORADO SPIRIT TRANSPORTATION, INC.

Provider Business Mailing Address
First Line	:	1642 S PARKER RD STE 307
Second Line	:
City	:	DENVER
State	:	CO
Zip	:	80231-2917
Country	:	US
Telephone Number	:	303-695-8888
Fax Number	:

Provider Business Practice Location Address
First Line	:	1642 S PARKER RD STE 307
Second Line	:
City	:	DENVER
State	:	CO
Zip	:	80231-2917
Country	:	US
Telephone Number	:	303-695-8888
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	DILOVAR ABDULLOEV
Credential	:
Telephone Number	:	303-695-8888

Provider Enumeration Date	:	04/01/2009
Last Update Date	:	04/01/2009

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