Provider Demographics
NPI:1093851784
Name:HUGO DIAZ MENCHO (DBA)TRANSPORTES XELAJU
Entity Type:Organization
Organization Name:HUGO DIAZ MENCHO (DBA)TRANSPORTES XELAJU
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:HUGO
Authorized Official - Middle Name:DIAZ
Authorized Official - Last Name:MENCHO
Authorized Official - Suffix:
Authorized Official - Credentials:STS373269
Authorized Official - Phone:612-964-3555
Mailing Address - Street 1:820 W 65TH ST APT 110
Mailing Address - Street 2:
Mailing Address - City:RICHFIELD
Mailing Address - State:MN
Mailing Address - Zip Code:55423-1311
Mailing Address - Country:US
Mailing Address - Phone:612-964-3555
Mailing Address - Fax:
Practice Address - Street 1:820 W 65TH ST APT 110
Practice Address - Street 2:
Practice Address - City:RICHFIELD
Practice Address - State:MN
Practice Address - Zip Code:55423-1311
Practice Address - Country:US
Practice Address - Phone:612-964-3555
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-29
Last Update Date:2008-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNSTS373269343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)