Provider Demographics
NPI:1043598048
Name:TARPEH, ALBERT GOETHE
Entity Type:Individual
Prefix:
First Name:ALBERT
Middle Name:GOETHE
Last Name:TARPEH
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7714 BROOKLYN BLVD STE 200-D
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN PARK
Mailing Address - State:MN
Mailing Address - Zip Code:55443-2936
Mailing Address - Country:US
Mailing Address - Phone:612-695-4971
Mailing Address - Fax:
Practice Address - Street 1:7714 BROOKLYN BLVD STE 200-D
Practice Address - Street 2:
Practice Address - City:BROOKLYN PARK
Practice Address - State:MN
Practice Address - Zip Code:55443-2936
Practice Address - Country:US
Practice Address - Phone:612-695-4971
Practice Address - Fax:763-269-6021
Is Sole Proprietor?:Yes
Enumeration Date:2011-07-26
Last Update Date:2011-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN376353343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)