MEDICARE: WOBI TRANSPORTATION LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	343900000X	Non-emergency Medical Transport (VAN)

General Provider Information

NPI Number	:	1053133231
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	WOBI TRANSPORTATION LLC

Provider Business Mailing Address
First Line	:	2246 7TH ST W APT 1
Second Line	:
City	:	SAINT PAUL
State	:	MN
Zip	:	55116-2876
Country	:	US
Telephone Number	:	776-447-1305
Fax Number	:

Provider Business Practice Location Address
First Line	:	2246 7TH ST W APT 1
Second Line	:
City	:	SAINT PAUL
State	:	MN
Zip	:	55116-2876
Country	:	US
Telephone Number	:	776-447-1305
Fax Number	:

Authorized Official
Title or Position	:	MANAGER
Name	:	ABU ABDRUKADIR DUBALE
Credential	:	OWNER
Telephone Number	:	763-447-1305

Provider Enumeration Date	:	10/29/2024
Last Update Date	:	11/18/2024

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