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General NPI Number Information
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NPI Number | 1801783436
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Entity Type | Organization
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Legal Business Name | KOLE TRANSPORTATION
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Dates
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Enumeration Date | 06/18/2025
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Last Update Date | 06/18/2025
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Provider Practice Location Address
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Address Line | 3016 80TH AVE N
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City | BROOKLYN PARK
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State | MN
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Zip | 55444-1836
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Country | US
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Telephone | 612-518-2835
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Fax |
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Provider Business Mailing Address
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Address Line | 3016 80TH AVE N
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City | BROOKLYN PARK
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State | MN
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Zip | 55444-1836
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Country | US
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Telephone | 612-518-2835
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Fax |
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Authorized Official
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Title or Position | SOLE PROPRIETOR/DRIVER
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Name | LILIAN D KABA
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Credential | STS PROVIDER
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Telephone | 952-686-4685
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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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