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NPI Code Detail

MEDICARE: NEW VISION TRANSPORTATION L.L.C

MEDICARE: NEW VISION TRANSPORTATION L.L.C
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
1343900000XNon-emergency Medical Transport (VAN)376376MN

General Provider Information

NPI Number : 1598034548
Entity Type Code : Organization
Provider Name (Legal Business Name) : NEW VISION TRANSPORTATION L.L.C
Provider Business Mailing Address
First Line : 2441 YOUNGMAN AVE APT 2C
Second Line : APT 2C
City : SAINT PAUL
State : MN
Zip : 55116-3043
Country : US
Telephone Number : 651-354-1770
Fax Number :
Provider Business Practice Location Address
First Line : 2441 YOUNGMAN AVE
Second Line : APT 2C
City : SAINT PAUL
State : MN
Zip : 55116-3064
Country : US
Telephone Number : 651-354-1770
Fax Number :
Authorized Official
Title or Position : OWNER OR MANAGER
Name : MR. EDAO HAWIYA BUKULA
Credential :
Telephone Number : 651-354-1770
Provider Enumeration Date : 12/20/2011
Last Update Date : 12/20/2011

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Directions to “NEW VISION TRANSPORTATION L.L.C ” Practice Location

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