Provider Demographics
NPI:1336429307
Name:MIDTOWN EXPRESS TRANSPORTATION SERVICES INC.
Entity Type:Organization
Organization Name:MIDTOWN EXPRESS TRANSPORTATION SERVICES INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ALEX
Authorized Official - Middle Name:
Authorized Official - Last Name:GABBANO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:303-282-8085
Mailing Address - Street 1:60 S HAVANA ST #605
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80012
Mailing Address - Country:US
Mailing Address - Phone:303-282-8085
Mailing Address - Fax:303-367-2141
Practice Address - Street 1:60 S HAVANA ST #605
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80012
Practice Address - Country:US
Practice Address - Phone:303-282-8085
Practice Address - Fax:303-367-2141
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-08-23
Last Update Date:2020-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COB9819343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO75738767Medicaid