Provider Demographics
NPI:1154856524
Name:MUDE TRANSPORTATION INC
Entity Type:Organization
Organization Name:MUDE TRANSPORTATION INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:SIYAD
Authorized Official - Middle Name:MUSSE
Authorized Official - Last Name:MAHAMED
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:320-295-0275
Mailing Address - Street 1:1712 MONONGALIA AVE SW
Mailing Address - Street 2:
Mailing Address - City:WILLMAR
Mailing Address - State:MN
Mailing Address - Zip Code:56201-2873
Mailing Address - Country:US
Mailing Address - Phone:320-295-0275
Mailing Address - Fax:
Practice Address - Street 1:1712 MONONGALIA AVE SW AP1
Practice Address - Street 2:
Practice Address - City:WILLMAR
Practice Address - State:MN
Practice Address - Zip Code:56201
Practice Address - Country:US
Practice Address - Phone:320-295-0275
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-04-24
Last Update Date:2017-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)