=====================================================
General NPI Number Information
=====================================================
NPI Number | 1558527440
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | GUARDIAN TRANSPORTATION INC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 07/31/2008
-----------------------------------------------------
Last Update Date | 07/31/2008
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 7800 METRO PKWY SUITE 217
-----------------------------------------------------
City | BLOOMINGTON
-----------------------------------------------------
State | MN
-----------------------------------------------------
Zip | 55425-1514
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 952-595-9030
-----------------------------------------------------
Fax | 952-595-9065
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 7800 METRO PKWY SUITE 217
-----------------------------------------------------
City | BLOOMINGTON
-----------------------------------------------------
State | MN
-----------------------------------------------------
Zip | 55425-1514
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 952-595-9030
-----------------------------------------------------
Fax | 952-595-9065
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PRESIDENT
-----------------------------------------------------
Name | MR. DIBA SOBHANI
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 952-595-9030
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 343900000X
-----------------------------------------------------
Taxonomy Name | Non-emergency Medical Transport (VAN)
-----------------------------------------------------
License Number | 327400
-----------------------------------------------------
License Number State | MN
-----------------------------------------------------