Provider Demographics
NPI:1194191080
Name:GOLF TRANSPORTATION LLC
Entity Type:Organization
Organization Name:GOLF TRANSPORTATION LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:NURADIN
Authorized Official - Middle Name:
Authorized Official - Last Name:ABDISHIKUR
Authorized Official - Suffix:
Authorized Official - Credentials:OWNER
Authorized Official - Phone:763-318-4801
Mailing Address - Street 1:3550 LEXINGTON AVE N
Mailing Address - Street 2:SUITE 101B
Mailing Address - City:SHOREVIEW
Mailing Address - State:MN
Mailing Address - Zip Code:55126-8075
Mailing Address - Country:US
Mailing Address - Phone:763-318-4801
Mailing Address - Fax:763-201-7774
Practice Address - Street 1:3550 LEXINGTON AVE N
Practice Address - Street 2:SUITE 101B
Practice Address - City:SHOREVIEW
Practice Address - State:MN
Practice Address - Zip Code:55126-5406
Practice Address - Country:US
Practice Address - Phone:763-318-4801
Practice Address - Fax:763-201-7774
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-08-14
Last Update Date:2016-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)