Provider Demographics
NPI:1215717871
Name:EXPRESS LIMO LLC
Entity type:Organization
Organization Name:EXPRESS LIMO LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:KITACHEW
Authorized Official - Middle Name:T
Authorized Official - Last Name:ABEBE
Authorized Official - Suffix:
Authorized Official - Credentials:PROJECT MANAGEMENT
Authorized Official - Phone:303-500-9544
Mailing Address - Street 1:4527 N QUATAR CT
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80019-3612
Mailing Address - Country:US
Mailing Address - Phone:303-500-9544
Mailing Address - Fax:
Practice Address - Street 1:2175 ACADEMY CIR STE 201-2
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80909-1695
Practice Address - Country:US
Practice Address - Phone:303-500-9544
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-10-02
Last Update Date:2023-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)