Provider Demographics
NPI:1679330377
Name:LUCKY YOU LLC TRANSPORTATION
Entity type:Organization
Organization Name:LUCKY YOU LLC TRANSPORTATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:YEMANE
Authorized Official - Middle Name:
Authorized Official - Last Name:TEKLEAB
Authorized Official - Suffix:
Authorized Official - Credentials:OWNER
Authorized Official - Phone:720-468-9527
Mailing Address - Street 1:19309 E 50TH DR
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80249-8472
Mailing Address - Country:US
Mailing Address - Phone:720-468-9527
Mailing Address - Fax:
Practice Address - Street 1:19309 E 50TH DR
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80249-8472
Practice Address - Country:US
Practice Address - Phone:720-468-9527
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-02-29
Last Update Date:2024-02-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)