Healthcare Provider Details

I. General information

NPI: 1215716451
Provider Name (Legal Business Name): BISMARCK TRANSPORTATION SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/27/2023
Last Update Date: 08/28/2024
Certification Date: 08/28/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4326 TRENTON DR
BISMARCK ND
58503-1167
US

IV. Provider business mailing address

4326 TRENTON DR
BISMARCK ND
58503-1167
US

V. Phone/Fax

Practice location:
  • Phone: 701-300-0718
  • Fax: 701-425-0446
Mailing address:
  • Phone: 701-300-0718
  • Fax: 701-425-0446

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code344600000X
TaxonomyTaxi
License Number
License Number State

VIII. Authorized Official

Name: JENNIFER O GYENIAW
Title or Position: MANAGER
Credential:
Phone: 701-300-0718