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NPI Code Detail

MEDICARE: MAVI TRANSPORTATION LLC

MEDICARE: MAVI TRANSPORTATION 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
1343900000XNon-emergency Medical Transport (VAN)

General Provider Information

NPI Number : 1780275446
Entity Type Code : Organization
Provider Name (Legal Business Name) : MAVI TRANSPORTATION LLC
Provider Business Mailing Address
First Line : 9201 E MISSISSIPPI AVE APT M105
Second Line :
City : DENVER
State : CO
Zip : 80247-6823
Country : US
Telephone Number : 303-642-5687
Fax Number :
Provider Business Practice Location Address
First Line : 9201 E MISSISSIPPI AVE APT M105
Second Line :
City : DENVER
State : CO
Zip : 80247-6823
Country : US
Telephone Number : 303-642-5687
Fax Number :
Authorized Official
Title or Position : MANAGER
Name : MESFIN GIZAW
Credential :
Telephone Number : 303-642-5687
Provider Enumeration Date : 01/26/2021
Last Update Date : 01/26/2021

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Directions to “MAVI TRANSPORTATION LLC ” Practice Location

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