Provider Demographics
NPI:1700570306
Name:BAHRAY MEDICAL TRANSPORTATION LLC
Entity Type:Organization
Organization Name:BAHRAY MEDICAL TRANSPORTATION LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/MANGER
Authorized Official - Prefix:
Authorized Official - First Name:EYASU
Authorized Official - Middle Name:BAHRAY
Authorized Official - Last Name:HAILMICHAEL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:303-332-3054
Mailing Address - Street 1:2175 ACADEMY CIR STE 8
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPGS
Mailing Address - State:CO
Mailing Address - Zip Code:80909-1682
Mailing Address - Country:US
Mailing Address - Phone:303-332-3054
Mailing Address - Fax:
Practice Address - Street 1:2175 ACADEMY CIR STE 8
Practice Address - Street 2:
Practice Address - City:COLORADO SPGS
Practice Address - State:CO
Practice Address - Zip Code:80909-1682
Practice Address - Country:US
Practice Address - Phone:303-332-3054
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-06-06
Last Update Date:2023-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes347C00000XTransportation ServicesPrivate Vehicle