Provider Demographics
NPI:1114208097
Name:AIRPORT EXPRESS SUPER TAXI
Entity Type:Organization
Organization Name:AIRPORT EXPRESS SUPER TAXI
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BUSINESS OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:AWALE
Authorized Official - Middle Name:
Authorized Official - Last Name:TAHIRO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:651-203-3402
Mailing Address - Street 1:1821 UNIVERSITY AVE W
Mailing Address - Street 2:SUITE S-318
Mailing Address - City:SAINT PAUL
Mailing Address - State:MN
Mailing Address - Zip Code:55104-2801
Mailing Address - Country:US
Mailing Address - Phone:612-349-9999
Mailing Address - Fax:
Practice Address - Street 1:1821 UNIVERSITY AVE W
Practice Address - Street 2:SUITE S-318
Practice Address - City:SAINT PAUL
Practice Address - State:MN
Practice Address - Zip Code:55104-2801
Practice Address - Country:US
Practice Address - Phone:612-349-9999
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-09-06
Last Update Date:2011-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNL256 50026343900000X, 344600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
No344600000XTransportation ServicesTaxi