Provider Demographics
NPI:1467510784
Name:MEDESTER LLC
Entity Type:Organization
Organization Name:MEDESTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:GIRMA
Authorized Official - Middle Name:DEJENE
Authorized Official - Last Name:TADESSE
Authorized Official - Suffix:I
Authorized Official - Credentials:
Authorized Official - Phone:510-672-2069
Mailing Address - Street 1:1013 PARDEE ST STE 211
Mailing Address - Street 2:
Mailing Address - City:BERKELEY
Mailing Address - State:CA
Mailing Address - Zip Code:94710-2646
Mailing Address - Country:US
Mailing Address - Phone:510-666-8666
Mailing Address - Fax:510-740-3603
Practice Address - Street 1:1013 PARDEE ST STE 211
Practice Address - Street 2:
Practice Address - City:BERKELEY
Practice Address - State:CA
Practice Address - Zip Code:94710-2646
Practice Address - Country:US
Practice Address - Phone:510-666-8666
Practice Address - Fax:510-740-3603
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-06
Last Update Date:2015-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA200640009614343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)