Healthcare Provider Details

I. General information

NPI: 1942119847
Provider Name (Legal Business Name): REAL TIME TRANSPORTATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/04/2026
Last Update Date: 09/04/2026
Certification Date: 09/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5019 RAMSLUND AVE NE
OTSEGO MN
55374-4975
US

IV. Provider business mailing address

5019 RAMSLUND AVE NE
OTSEGO MN
55374-4975
US

V. Phone/Fax

Practice location:
  • Phone: 612-702-6716
  • Fax:
Mailing address:
  • Phone: 612-702-6716
  • Fax: 612-722-1236

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License Number
License Number State

VIII. Authorized Official

Name: EDOSA WADAJO TABELU
Title or Position: MANAGER
Credential:
Phone: 612-702-6716