Provider Demographics
NPI:1982075842
Name:XANADU 2 CORPORATION
Entity Type:Organization
Organization Name:XANADU 2 CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:BRADLEY
Authorized Official - Last Name:RAIL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:720-425-7285
Mailing Address - Street 1:1391 XANADU ST
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80011-6532
Mailing Address - Country:US
Mailing Address - Phone:303-364-9630
Mailing Address - Fax:
Practice Address - Street 1:1391 XANADU ST
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80011-6532
Practice Address - Country:US
Practice Address - Phone:303-364-9630
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-10-16
Last Update Date:2016-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)