Provider Demographics
NPI:1376076497
Name:LUCY LIMO LLC
Entity Type:Organization
Organization Name:LUCY LIMO LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ABDUSELAM
Authorized Official - Middle Name:S
Authorized Official - Last Name:MUME
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:303-960-1753
Mailing Address - Street 1:14190 E KENTUCKY PL APT 304
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80012-3667
Mailing Address - Country:US
Mailing Address - Phone:303-960-1753
Mailing Address - Fax:
Practice Address - Street 1:1150 SYRACUSE ST APT 4-51
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80220-3207
Practice Address - Country:US
Practice Address - Phone:303-960-1753
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-04-05
Last Update Date:2017-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)