Provider Demographics
NPI:1760260640
Name:PRIORITY CARE TRANSPORT LLC
Entity Type:Organization
Organization Name:PRIORITY CARE TRANSPORT LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MELKAMU
Authorized Official - Middle Name:G
Authorized Official - Last Name:MENGESHA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:857-800-4566
Mailing Address - Street 1:4441 ASHER HTS APT 208
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80917-6417
Mailing Address - Country:US
Mailing Address - Phone:857-800-4566
Mailing Address - Fax:
Practice Address - Street 1:4441 ASHER HTS APT 208
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80917-6417
Practice Address - Country:US
Practice Address - Phone:857-800-4566
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-09-20
Last Update Date:2023-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)