Provider Demographics
NPI:1063153302
Name:COLORADO WHEELCHAIR TRANSPORTATION, LLC
Entity type:Organization
Organization Name:COLORADO WHEELCHAIR TRANSPORTATION, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ANDREY
Authorized Official - Middle Name:
Authorized Official - Last Name:SCHUROV
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:720-840-0949
Mailing Address - Street 1:7865 E MISSISSIPPI AVE APT 303
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80247-2032
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:7865 E MISSISSIPPI AVE APT 303
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80247-2032
Practice Address - Country:US
Practice Address - Phone:720-840-0949
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-04-01
Last Update Date:2022-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO9000190788Medicaid