Provider Demographics
NPI:1770364994
Name:CAIN, ANTONIO DARSHAUN
Entity type:Individual
Prefix:
First Name:ANTONIO
Middle Name:DARSHAUN
Last Name:CAIN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19143 E 54TH PL
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80249-8750
Mailing Address - Country:US
Mailing Address - Phone:773-671-7303
Mailing Address - Fax:
Practice Address - Street 1:19143 E 54TH PL
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80249-8750
Practice Address - Country:US
Practice Address - Phone:773-671-7303
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-10-12
Last Update Date:2023-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)