Provider Demographics
NPI:1639550528
Name:ARK MEDICAL TRANSPORT INC.
Entity Type:Organization
Organization Name:ARK MEDICAL TRANSPORT INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:HAILE
Authorized Official - Middle Name:
Authorized Official - Last Name:ABAY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:720-999-4145
Mailing Address - Street 1:1374 S ZENO ST
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80017-4324
Mailing Address - Country:US
Mailing Address - Phone:720-999-4145
Mailing Address - Fax:
Practice Address - Street 1:1374 S ZENO ST
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80017-4324
Practice Address - Country:US
Practice Address - Phone:720-999-4145
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-06-16
Last Update Date:2015-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COB09988343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)