Healthcare Provider Details

I. General information

NPI: 1841069408
Provider Name (Legal Business Name): MO EXPRESS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/25/2023
Last Update Date: 01/25/2024
Certification Date: 01/25/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

325 33RD AVE N
SAINT CLOUD MN
56303-3041
US

IV. Provider business mailing address

1060 7TH ST SE APT 304
SAINT CLOUD MN
56304-1558
US

V. Phone/Fax

Practice location:
  • Phone: 320-217-2630
  • Fax:
Mailing address:
  • Phone: 320-333-0049
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code342000000X
TaxonomyTransportation Network Company
License Number
License Number State

VIII. Authorized Official

Name: MOHAMED SALAT ALI
Title or Position: OWNER
Credential:
Phone: 320-333-0049