Provider Demographics
NPI:1629778774
Name:LEREZO LLC
Entity Type:Organization
Organization Name:LEREZO LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MOOJAN
Authorized Official - Middle Name:
Authorized Official - Last Name:SHARIFI ARANI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:531-247-9588
Mailing Address - Street 1:9011 BURT ST APT 207
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68114-2445
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:9011 BURT ST APT 207
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68114-2445
Practice Address - Country:US
Practice Address - Phone:531-247-9588
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-03-07
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)