Provider Demographics
NPI:1124209895
Name:METRO AREA TRANSIT
Entity Type:Organization
Organization Name:METRO AREA TRANSIT
Other - Org Name:CITY OF FARGO
Other - Org Type:Doing Business As
Authorized Official - Title/Position:FARGO TRANSIT ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:JULIE
Authorized Official - Middle Name:
Authorized Official - Last Name:BOMMELMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:701-476-6737
Mailing Address - Street 1:650 23RD ST N
Mailing Address - Street 2:
Mailing Address - City:FARGO
Mailing Address - State:ND
Mailing Address - Zip Code:58102-4100
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:650 23RD ST N
Practice Address - Street 2:
Practice Address - City:FARGO
Practice Address - State:ND
Practice Address - Zip Code:58102-4100
Practice Address - Country:US
Practice Address - Phone:701-241-8140
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-21
Last Update Date:2007-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NDGOV'T AGENCY347B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes347B00000XTransportation ServicesBus
Provider Identifiers
StateIdentifier IDID TypeIssuer
ND55050Medicaid