Provider Demographics
NPI:1720863210
Name:M LIGHT TRANSPORTATION LLC
Entity Type:Organization
Organization Name:M LIGHT TRANSPORTATION LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:MEBRAT
Authorized Official - Middle Name:
Authorized Official - Last Name:GEBREMARIAM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:720-400-5852
Mailing Address - Street 1:7226 S VANDRIVER WAY
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80016-5121
Mailing Address - Country:US
Mailing Address - Phone:720-400-5852
Mailing Address - Fax:
Practice Address - Street 1:7226 S VANDRIVER WAY
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80016-5121
Practice Address - Country:US
Practice Address - Phone:720-400-5852
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-08-31
Last Update Date:2023-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes347C00000XTransportation ServicesPrivate Vehicle
No332U00000XSuppliersHome Delivered Meals
No342000000XTransportation ServicesTransportation Network Company
No343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
No347E00000XTransportation ServicesTransportation Broker