Provider Demographics
NPI:1679222616
Name:TEKLU- ADAM LLC
Entity Type:Organization
Organization Name:TEKLU- ADAM LLC
Other - Org Name:ALL GO TRANSPORTATION LLC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:HELMI
Authorized Official - Middle Name:ABRAHA
Authorized Official - Last Name:TEKLU
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:607-644-8550
Mailing Address - Street 1:6 AUTOMATION LN STE 122
Mailing Address - Street 2:
Mailing Address - City:ALBANY
Mailing Address - State:NY
Mailing Address - Zip Code:12205-1658
Mailing Address - Country:US
Mailing Address - Phone:607-644-8550
Mailing Address - Fax:
Practice Address - Street 1:6 AUTOMATION LN STE 122
Practice Address - Street 2:
Practice Address - City:ALBANY
Practice Address - State:NY
Practice Address - Zip Code:12205-1658
Practice Address - Country:US
Practice Address - Phone:607-644-8550
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-03-18
Last Update Date:2022-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
No344600000XTransportation ServicesTaxi
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY05989560Medicaid