Healthcare Provider Details

I. General information

NPI: 1457286353
Provider Name (Legal Business Name): MR. KHALEEL ALMOSAWI SR.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/15/2026
Last Update Date: 06/15/2026
Certification Date: 06/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4301 PARK GLEN RD APT 222
MINNEAPOLIS MN
55416-4772
US

IV. Provider business mailing address

4301 PARK GLEN RD APT 222
MINNEAPOLIS MN
55416-4772
US

V. Phone/Fax

Practice location:
  • Phone: 612-248-1588
  • Fax:
Mailing address:
  • Phone: 612-248-1588
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License NumberJ980-176-860-517
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: