Provider Demographics
NPI:1407394554
Name:COMFORT LIMO EXPRESS
Entity Type:Organization
Organization Name:COMFORT LIMO EXPRESS
Other - Org Name:COMFORT LIMO EXPRESS
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ALMAZ
Authorized Official - Middle Name:DESALEGN
Authorized Official - Last Name:BAKALO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:720-579-5507
Mailing Address - Street 1:17632 E BROWN CIR
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80013-2186
Mailing Address - Country:US
Mailing Address - Phone:720-579-5507
Mailing Address - Fax:
Practice Address - Street 1:17632 E BROWN CIR
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80013-2186
Practice Address - Country:US
Practice Address - Phone:720-579-5507
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-02-09
Last Update Date:2017-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)