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General NPI Number Information
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NPI Number | 1477356418
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Entity Type | Organization
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Legal Business Name | LAND OF LAKES TRANSPORTATION LLC
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Dates
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Enumeration Date | 03/27/2025
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Last Update Date | 03/27/2025
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Provider Practice Location Address
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Address Line | 2405 COUNTY ROAD 74 APT 258
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City | SAINT CLOUD
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State | MN
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Zip | 56301-2214
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Country | US
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Telephone | 612-986-5653
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Fax |
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Provider Business Mailing Address
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Address Line | 2405 COUNTY ROAD 74 APT 258
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City | SAINT CLOUD
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State | MN
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Zip | 56301-2214
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Country | US
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Telephone | 612-986-5653
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | ABDULLAHI ODOWAA
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Credential | NON EMERGENCY TRANSP
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Telephone | 612-986-5653
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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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