MEDICARE: TRIPLE H TRANSPORTATION

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	:	1841665080
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TRIPLE H TRANSPORTATION

Provider Business Mailing Address
First Line	:	200 WINTHROP ST S APT 132
Second Line	:
City	:	SAINT PAUL
State	:	MN
Zip	:	55119-5037
Country	:	US
Telephone Number	:	612-756-0558
Fax Number	:

Provider Business Practice Location Address
First Line	:	200 WINTHROP ST S APT 132
Second Line	:
City	:	SAINT PAUL
State	:	MN
Zip	:	55119-5037
Country	:	US
Telephone Number	:	612-756-0558
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	SAID ABDIKARIN DUALE
Credential	:
Telephone Number	:	612-756-0558

Provider Enumeration Date	:	12/12/2015
Last Update Date	:	12/12/2015

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