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General NPI Number Information
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NPI Number | 1245067503
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Entity Type | Organization
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Legal Business Name | ACTIVE TRANSPORTATION SERVICES LLC
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Dates
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Enumeration Date | 09/19/2024
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Last Update Date | 09/25/2024
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Provider Practice Location Address
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Address Line | 3815 BURQUEST LN
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City | BROOKLYN CENTER
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State | MN
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Zip | 55429-3028
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Country | US
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Telephone | 612-876-2440
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Fax |
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Provider Business Mailing Address
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Address Line | 3815 BURQUEST LN
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City | BROOKLYN CENTER
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State | MN
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Zip | 55429-3028
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Country | US
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Telephone | 612-876-2440
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Fax |
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Authorized Official
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Title or Position | TRANSPORTATION MANAGER
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Name | MOFOBA MUSA KANNEH
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Credential | MOFOBA MUSA KANNEH
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Telephone | 612-876-2440
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 343800000X
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Taxonomy Name | Secured Medical Transport (VAN)
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 343900000X
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Taxonomy Name | Non-emergency Medical Transport (VAN)
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 347C00000X
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Taxonomy Name | Private Vehicle
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 342000000X
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Taxonomy Name | Transportation Network Company
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License Number |
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License Number State |
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