Healthcare Provider Details

I. General information

NPI: 1447620802
Provider Name (Legal Business Name): GS TRANSPORTATION LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/29/2015
Last Update Date: 09/29/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

175 CHARLES AVE
SAINT PAUL MN
55103-2054
US

IV. Provider business mailing address

175 CHARLES AVE
SAINT PAUL MN
55103-2054
US

V. Phone/Fax

Practice location:
  • Phone: 763-496-9455
  • Fax:
Mailing address:
  • Phone:
  • Fax:

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: ABDO OMER GUYE
Title or Position: OWNER/MANAGER
Credential:
Phone: 763-568-6363