Healthcare Provider Details

I. General information

NPI: 1699673525
Provider Name (Legal Business Name): YOSEPH GETAHUN
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/29/2026
Last Update Date: 10/29/2026
Certification Date: 10/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1531 32ND AVE S STE 102
FARGO ND
58103-5911
US

IV. Provider business mailing address

600 8TH ST S APT 204
MOORHEAD MN
56560-3537
US

V. Phone/Fax

Practice location:
  • Phone: 701-991-5277
  • 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:
Title or Position:
Credential:
Phone: