Provider Demographics
NPI:1265272488
Name:BESTWAY MIRAGE TRANSPORT SERVICES LLC
Entity type:Organization
Organization Name:BESTWAY MIRAGE TRANSPORT SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:JOVANNA
Authorized Official - Middle Name:
Authorized Official - Last Name:PITTMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:720-908-6416
Mailing Address - Street 1:14465 MONTVIEW BLVD UNIT 922
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80011-4311
Mailing Address - Country:US
Mailing Address - Phone:720-908-6416
Mailing Address - Fax:
Practice Address - Street 1:1800 WAZEE ST STE 300
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80202-2526
Practice Address - Country:US
Practice Address - Phone:720-908-6416
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-05-27
Last Update Date:2024-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)