Provider Demographics
NPI:1114370947
Name:1ST A LIMOUSINE@DENVER LLC
Entity Type:Organization
Organization Name:1ST A LIMOUSINE@DENVER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANEGAR
Authorized Official - Prefix:MR
Authorized Official - First Name:ABDALBAGE
Authorized Official - Middle Name:MOKHTAR
Authorized Official - Last Name:ABU
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:720-276-7251
Mailing Address - Street 1:1000 S DAYTON ST
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80247-1902
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1000 S DAYTON ST
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80247-1902
Practice Address - Country:US
Practice Address - Phone:720-276-7251
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-07-17
Last Update Date:2016-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)