Healthcare Provider Details

I. General information

NPI: 1184910002
Provider Name (Legal Business Name): ALKHALEEJ INTERNATIONAL LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/20/2011
Last Update Date: 06/20/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 1ST AVE SW STE 205
ROCHESTER MN
55902-3159
US

IV. Provider business mailing address

100 1ST AVE SW
ROCHESTER MN
55902-3156
US

V. Phone/Fax

Practice location:
  • Phone: 507-269-7800
  • Fax: 763-529-8080
Mailing address:
  • Phone: 507-269-7800
  • Fax: 763-529-8080

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2355S0801X
TaxonomySpeech-Language Assistant
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License Number
License Number StateMN

VIII. Authorized Official

Name: MRS. AYOUB ABDALLA MOHAMED
Title or Position: OWNER
Credential:
Phone: 507-269-7800