Provider Demographics
NPI:1235652033
Name:NORTHSTAR STS TRANSPORT LLC
Entity Type:Organization
Organization Name:NORTHSTAR STS TRANSPORT LLC
Other - Org Name:ROVER TRUCKING LLC
Other - Org Type:Other Name
Authorized Official - Title/Position:OWNER/MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:HASSAN
Authorized Official - Middle Name:
Authorized Official - Last Name:SHARIF
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:952-457-5408
Mailing Address - Street 1:PO BOX 2147
Mailing Address - Street 2:
Mailing Address - City:BURNSVILLE
Mailing Address - State:MN
Mailing Address - Zip Code:55337-0007
Mailing Address - Country:US
Mailing Address - Phone:952-457-5408
Mailing Address - Fax:
Practice Address - Street 1:20657 KAISER WAY
Practice Address - Street 2:
Practice Address - City:LAKEVILLE
Practice Address - State:MN
Practice Address - Zip Code:55044-6715
Practice Address - Country:US
Practice Address - Phone:952-457-5408
Practice Address - Fax:612-278-2277
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-07-24
Last Update Date:2017-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)