MEDICARE: MDY 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
1	343900000X	Non-emergency Medical Transport (VAN)

General Provider Information

NPI Number	:	1790485399
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MDY TRANSPORTATION LLC

Provider Business Mailing Address
First Line	:	8680 E ALAMEDA AVE APT 1232
Second Line	:
City	:	DENVER
State	:	CO
Zip	:	80247-6512
Country	:	US
Telephone Number	:	720-400-2035
Fax Number	:

Provider Business Practice Location Address
First Line	:	8680 E ALAMEDA AVE APT 1232
Second Line	:
City	:	DENVER
State	:	CO
Zip	:	80247-6512
Country	:	US
Telephone Number	:	720-400-2035
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	YOSEF LEMMA ZELEKE
Credential	:
Telephone Number	:	720-400-2035

Provider Enumeration Date	:	03/03/2023
Last Update Date	:	03/03/2023

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