Healthcare Provider Details

I. General information

NPI: 1316104052
Provider Name (Legal Business Name): MINNESOTA IMMIGRANT SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/20/2008
Last Update Date: 05/20/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1405 MARION RD SE 107
ROCHESTER MN
55904-2741
US

IV. Provider business mailing address

PO BOX 8492
ROCHESTER MN
55903-8492
US

V. Phone/Fax

Practice location:
  • Phone: 507-280-4029
  • Fax: 507-281-1107
Mailing address:
  • Phone: 507-280-4029
  • Fax: 507-281-1107

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171R00000X
TaxonomyInterpreter
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License Number
License Number State

VIII. Authorized Official

Name: MUSTAFA SHARIF
Title or Position: PRESIDENT
Credential: COMMUNITY LEADER
Phone: 507-271-9254