Provider Demographics
NPI:1710332374
Name:DELTA TRANSPORT LLC
Entity Type:Organization
Organization Name:DELTA TRANSPORT LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:BETELHEM
Authorized Official - Middle Name:HAILE
Authorized Official - Last Name:YIMAM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:303-523-2013
Mailing Address - Street 1:2455 S LANSING WAY
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80014-1866
Mailing Address - Country:US
Mailing Address - Phone:303-523-2013
Mailing Address - Fax:
Practice Address - Street 1:1159 S WACO ST UNIT B
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80017-5769
Practice Address - Country:US
Practice Address - Phone:719-213-1186
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-05-02
Last Update Date:2021-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO55879343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)