MEDICARE: HANGGI DISPATCHING SERVICE

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)	34390000	MN

General Provider Information

NPI Number	:	1952768871
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HANGGI DISPATCHING SERVICE

Provider Business Mailing Address
First Line	:	3800 5TH ST NE
Second Line	:
City	:	COLUMBIA HEIGHTS
State	:	MN
Zip	:	55421-3702
Country	:	US
Telephone Number	:	651-230-0706
Fax Number	:

Provider Business Practice Location Address
First Line	:	3800 5TH ST NE
Second Line	:
City	:	COLUMBIA HEIGHTS
State	:	MN
Zip	:	55421-3702
Country	:	US
Telephone Number	:	651-230-0706
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	JBOUTI A JAMA
Credential	:
Telephone Number	:	651-230-0706

Provider Enumeration Date	:	01/22/2016
Last Update Date	:	01/22/2016

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