Provider Demographics
NPI:1225494594
Name:AMANNA MEDICAL TRANSPORTATION LLC
Entity Type:Organization
Organization Name:AMANNA MEDICAL TRANSPORTATION LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:MOHAMED
Authorized Official - Middle Name:FAISAL
Authorized Official - Last Name:MOHAMED
Authorized Official - Suffix:SR
Authorized Official - Credentials:
Authorized Official - Phone:612-814-7814
Mailing Address - Street 1:3355 HIAWATHA AVE STE 100
Mailing Address - Street 2:
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55406-2441
Mailing Address - Country:US
Mailing Address - Phone:612-814-7814
Mailing Address - Fax:612-808-8598
Practice Address - Street 1:3355 HIAWATHA AVE STE 100
Practice Address - Street 2:
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55406-2441
Practice Address - Country:US
Practice Address - Phone:612-814-7814
Practice Address - Fax:612-808-8598
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-01-02
Last Update Date:2016-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)