Provider Demographics
NPI:1700255759
Name:DENVER EXPRESS TRANSPORTATION
Entity Type:Organization
Organization Name:DENVER EXPRESS TRANSPORTATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:EYOB
Authorized Official - Middle Name:ASMELASH
Authorized Official - Last Name:BERHE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:720-216-3526
Mailing Address - Street 1:4671 ORLEANS ST
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80249-8071
Mailing Address - Country:US
Mailing Address - Phone:720-216-3526
Mailing Address - Fax:
Practice Address - Street 1:4671 ORLEANS ST
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80249-8071
Practice Address - Country:US
Practice Address - Phone:720-216-3526
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-09-21
Last Update Date:2015-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COB-10037343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)