Provider Demographics
NPI:1457719692
Name:GOLDEN MEDICAL TRANSPORTATION SERVICES
Entity Type:Organization
Organization Name:GOLDEN MEDICAL TRANSPORTATION SERVICES
Other - Org Name:N/A
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANAGING DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:CHUKS
Authorized Official - Middle Name:
Authorized Official - Last Name:IDIKA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:720-404-5377
Mailing Address - Street 1:1450 S HAVANA ST STE 232
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80012-4021
Mailing Address - Country:US
Mailing Address - Phone:720-404-5377
Mailing Address - Fax:303-693-6553
Practice Address - Street 1:1450 S HAVANA ST STE 232
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80012-4021
Practice Address - Country:US
Practice Address - Phone:720-404-5377
Practice Address - Fax:303-693-6553
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-02-02
Last Update Date:2021-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO22405364251C00000X, 253Z00000X, 261QD1600X, 385HR2065X
320900000X, 376J00000X
COB-09970343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes253Z00000XAgenciesIn Home Supportive Care
No251C00000XAgenciesDay Training, Developmentally Disabled Services
No261QD1600XAmbulatory Health Care FacilitiesClinic/CenterDevelopmental Disabilities
No320900000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities
No343900000XTransportation ServicesNon-emergency Medical Transport (VAN)Group - Multi-Specialty
No376J00000XNursing Service Related ProvidersHomemakerGroup - Multi-Specialty
No385HR2065XRespite Care FacilityRespite CareRespite Care, Physical Disabilities, Child
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO21439222Medicaid
CO22405364Medicaid