Provider Demographics
NPI:1427835982
Name:AREGA, MELAT
Entity type:Individual
Prefix:
First Name:MELAT
Middle Name:
Last Name:AREGA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19036 E 16TH PL
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80011-5280
Mailing Address - Country:US
Mailing Address - Phone:720-750-0754
Mailing Address - Fax:
Practice Address - Street 1:1755 TELSTAR DR
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80920-1016
Practice Address - Country:US
Practice Address - Phone:720-750-0754
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-09-08
Last Update Date:2023-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO20231468106343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)