Healthcare Provider Details

I. General information

NPI: 1083472484
Provider Name (Legal Business Name): MINNEAPOLIS REGIONAL TRANSPORTATION LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/11/2024
Last Update Date: 03/11/2024
Certification Date: 03/11/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1690 SILVER LAKE RD NW
SAINT PAUL MN
55112-1788
US

IV. Provider business mailing address

1690 SILVER LAKE RD NW
SAINT PAUL MN
55112-1788
US

V. Phone/Fax

Practice location:
  • Phone: 612-986-1900
  • Fax:
Mailing address:
  • Phone: 612-986-1900
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code172A00000X
TaxonomyDriver
License Number
License Number State

VIII. Authorized Official

Name: HARUN A ESSE
Title or Position: DRIVER
Credential:
Phone: 612-986-1900