MEDICARE: SAM 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	253Z00000X	In Home Supportive Care Agency

General Provider Information

NPI Number	:	1902732639
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SAM TRANSPORTATION LLC

Provider Business Mailing Address
First Line	:	15755 E CENTER AVE
Second Line	:
City	:	AURORA
State	:	CO
Zip	:	80017-2017
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	15755 E CENTER AVE
Second Line	:
City	:	AURORA
State	:	CO
Zip	:	80017-2017
Country	:	US
Telephone Number	:	720-297-2640
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	SOLOMON DEJENE
Credential	:
Telephone Number	:	720-297-2640

Provider Enumeration Date	:	06/22/2026
Last Update Date	:	06/22/2026

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Directions to “SAM TRANSPORTATION LLC ” Practice Location

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