Provider Demographics
NPI:1588204127
Name:MEDICARRIAGE LLC
Entity Type:Organization
Organization Name:MEDICARRIAGE LLC
Other - Org Name:MEDICARRIAGE LLC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:GEMECHU
Authorized Official - Middle Name:GUTETA
Authorized Official - Last Name:BULCHA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:385-477-7528
Mailing Address - Street 1:3610 OPAL CT
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80918-5530
Mailing Address - Country:US
Mailing Address - Phone:385-477-7528
Mailing Address - Fax:
Practice Address - Street 1:3610 OPAL CT
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80918-5530
Practice Address - Country:US
Practice Address - Phone:385-477-7527
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-01-12
Last Update Date:2020-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)Group - Single Specialty