Provider Demographics
NPI:1164159729
Name:GERSAM TRANSPORTATION LLC
Entity Type:Organization
Organization Name:GERSAM TRANSPORTATION LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:HAIMANOT
Authorized Official - Middle Name:AYEHU
Authorized Official - Last Name:AYEHU
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:720-757-2329
Mailing Address - Street 1:6756 E ARCHER DR
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80230-6757
Mailing Address - Country:US
Mailing Address - Phone:802-402-9345
Mailing Address - Fax:
Practice Address - Street 1:6756 E ARCHER DR
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80230-6757
Practice Address - Country:US
Practice Address - Phone:802-402-9345
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-08-03
Last Update Date:2022-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes347C00000XTransportation ServicesPrivate Vehicle