Provider Demographics
NPI:1235403437
Name:GASXPRESS
Entity Type:Organization
Organization Name:GASXPRESS
Other - Org Name:EXPRESS MOBILITY REPAIR
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ROANLD
Authorized Official - Middle Name:TODD
Authorized Official - Last Name:ONAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:303-465-2438
Mailing Address - Street 1:272 INCA ST
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80223-1327
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:272 INCA ST
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80223-1327
Practice Address - Country:US
Practice Address - Phone:303-465-2438
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:GASXPRESS
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2012-03-06
Last Update Date:2012-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies