Provider Demographics
NPI:1073213468
Name:WONGEAL LLC
Entity Type:Organization
Organization Name:WONGEAL LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:ZELALEM
Authorized Official - Middle Name:YIGZAW
Authorized Official - Last Name:AYELE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:720-936-1816
Mailing Address - Street 1:PO BOX 473722
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80047-3722
Mailing Address - Country:US
Mailing Address - Phone:720-936-1816
Mailing Address - Fax:
Practice Address - Street 1:17946 E 95TH AVE
Practice Address - Street 2:
Practice Address - City:COMMERCE CITY
Practice Address - State:CO
Practice Address - Zip Code:80022-9652
Practice Address - Country:US
Practice Address - Phone:720-936-1816
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-03-06
Last Update Date:2024-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
No342000000XTransportation ServicesTransportation Network Company