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General NPI Number Information
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NPI Number | 1619847167
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Entity Type | Organization
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Legal Business Name |
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Dates
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Enumeration Date | 11/10/2025
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Last Update Date | 11/10/2025
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Provider Practice Location Address
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Address Line | 9563 51ST ST NE
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City | SAINT MICHAEL
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State | MN
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Zip | 55376-7529
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Country | US
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Telephone | 651-210-1561
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Fax |
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Provider Business Mailing Address
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Address Line | 9563 51ST ST NE
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City | SAINT MICHAEL
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State | MN
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Zip | 55376-7529
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Country | US
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Telephone | 651-210-1561
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | ONDARI ERIC NYABUTO
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Credential |
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Telephone | 651-210-1561
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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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