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NPI Code Detail

MEDICARE: MR. NEGEDE M MAMMO

MEDICARE: MR. NEGEDE M MAMMO
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)9000207681CO

General Provider Information

NPI Number : 1861242661
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. NEGEDE M MAMMO
Provider Business Mailing Address
First Line : 1765 S 8TH ST STE 220
Second Line :
City : COLORADO SPRINGS
State : CO
Zip : 80905-7910
Country : US
Telephone Number : 720-495-7633
Fax Number :
Provider Business Practice Location Address
First Line : 1765 S 8TH ST STE 220
Second Line :
City : COLORADO SPRINGS
State : CO
Zip : 80905-7910
Country : US
Telephone Number : 720-495-7633
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/25/2024
Last Update Date : 03/25/2024

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Directions to “ MR. NEGEDE M MAMMO ” Practice Location

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