Healthcare Provider Details

I. General information

NPI: 1225962590
Provider Name (Legal Business Name): TRUSTPATH TRANSPORTATION LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/10/2026
Last Update Date: 06/10/2026
Certification Date: 06/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2800 E ENTERPRISE AVE STE 333
APPLETON WI
54913-7889
US

IV. Provider business mailing address

9710 37TH PL N APT 202
PLYMOUTH MN
55441-1835
US

V. Phone/Fax

Practice location:
  • Phone: 651-448-0192
  • Fax:
Mailing address:
  • Phone: 651-448-0192
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code342000000X
TaxonomyTransportation Network Company
License Number
License Number State

VIII. Authorized Official

Name: ABDIMALIK ABDI
Title or Position: OWNER
Credential:
Phone: 651-448-0192