Provider Demographics
NPI:1922540608
Name:EXCELLENCY MOBILITY
Entity type:Organization
Organization Name:EXCELLENCY MOBILITY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPERATION MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:OLUROTIMI
Authorized Official - Middle Name:MICHAEL
Authorized Official - Last Name:OWOKOYA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:720-849-3657
Mailing Address - Street 1:19133 E MILAN CIR
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80013-3661
Mailing Address - Country:US
Mailing Address - Phone:720-849-3657
Mailing Address - Fax:303-766-4587
Practice Address - Street 1:19133 E MILAN CIR
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80013-3661
Practice Address - Country:US
Practice Address - Phone:720-849-3657
Practice Address - Fax:303-766-4587
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-11-10
Last Update Date:2016-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COB10092343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)