Healthcare Provider Details

I. General information

NPI: 1124209895
Provider Name (Legal Business Name): METRO AREA TRANSIT
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/21/2007
Last Update Date: 11/21/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

650 23RD ST N
FARGO ND
58102-4100
US

IV. Provider business mailing address

650 23RD ST N
FARGO ND
58102-4100
US

V. Phone/Fax

Practice location:
  • Phone: 701-241-8140
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code347B00000X
TaxonomyBus
License NumberGOV'T AGENCY
License Number StateND

VIII. Authorized Official

Name: JULIE BOMMELMAN
Title or Position: FARGO TRANSIT ADMINISTRATOR
Credential:
Phone: 701-476-6737