Provider Demographics
NPI:1821466871
Name:MERCY MEDICAL TRANSPORTATION LLC
Entity Type:Organization
Organization Name:MERCY MEDICAL TRANSPORTATION LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:IRINA
Authorized Official - Middle Name:
Authorized Official - Last Name:BURILKOVA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:952-473-9999
Mailing Address - Street 1:15400 E BATAVIA DR
Mailing Address - Street 2:A-1
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80011-4608
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:15400 E BATAVIA DR
Practice Address - Street 2:A-1
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80011-4608
Practice Address - Country:US
Practice Address - Phone:952-473-9999
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-09-08
Last Update Date:2016-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO347E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes347E00000XTransportation ServicesTransportation Broker