MEDICARE: METRO CARE 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)	3839487	MN

General Provider Information

NPI Number	:	1700258092
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	METRO CARE TRANSPORTATION, LLC

Provider Business Mailing Address
First Line	:	9001 E BLOOMINGTON FWY
Second Line	:	SUITE 131
City	:	BLOOMINGTON
State	:	MN
Zip	:	55420-3435
Country	:	US
Telephone Number	:	952-314-9345
Fax Number	:	952-314-9346

Provider Business Practice Location Address
First Line	:	9001 E BLOOMINGTON FWY
Second Line	:	SUITE 131
City	:	BLOOMINGTON
State	:	MN
Zip	:	55420-3435
Country	:	US
Telephone Number	:	952-314-9345
Fax Number	:	952-314-9346

Authorized Official
Title or Position	:	MANAGING DIRECTOR
Name	:	ABDIRASHID O MOHAMED
Credential	:
Telephone Number	:	952-314-9345

Provider Enumeration Date	:	10/26/2015
Last Update Date	:	10/26/2015

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