Provider Demographics
NPI:1336827583
Name:DOMINION TRANSIT LLC
Entity Type:Organization
Organization Name:DOMINION TRANSIT LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:TEWODROS
Authorized Official - Middle Name:B
Authorized Official - Last Name:FOLLA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:303-994-1503
Mailing Address - Street 1:10808 TROY ST
Mailing Address - Street 2:
Mailing Address - City:COMMERCE CITY
Mailing Address - State:CO
Mailing Address - Zip Code:80022-6639
Mailing Address - Country:US
Mailing Address - Phone:303-994-1503
Mailing Address - Fax:
Practice Address - Street 1:118 W RAILROAD AVE
Practice Address - Street 2:
Practice Address - City:FORT MORGAN
Practice Address - State:CO
Practice Address - Zip Code:80701-2127
Practice Address - Country:US
Practice Address - Phone:303-994-1503
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-07-07
Last Update Date:2023-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)