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NPI 1912364688

NPI 1912364688 : HUDSON TRANSPORTATION : BLOOMINGTON, MN

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General NPI Number Information
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    NPI Number           |    1912364688
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    Entity Type          |    Organization 
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    Legal Business Name  |    HUDSON TRANSPORTATION 
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Dates
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    Enumeration Date     |    01/26/2016
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    Last Update Date     |    01/26/2016
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Provider Practice Location Address
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    Address Line         |    10650 BRUNSWICK RD APT 316 
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    City                 |    BLOOMINGTON
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    State                |    MN
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    Zip                  |    55438-1857
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    Country              |    US
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    Telephone            |    202-812-7001
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    Fax                  |    612-821-2385
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Provider Business Mailing Address
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    Address Line         |    10650 BRUNSWICK RD APT 316 
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    City                 |    BLOOMINGTON
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    State                |    MN
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    Zip                  |    55438-1857
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    Country              |    US
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    Telephone            |    202-812-7001
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    Fax                  |    
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Authorized Official
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    Title or Position    |    OWNER
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    Name                 |     AYANLE MOHAMED IBRAHIM 
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    Credential           |    
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    Telephone            |    202-812-7001
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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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