Provider Demographics
NPI:1346532454
Name:VIKING AIRPORT TAXI LLC
Entity Type:Organization
Organization Name:VIKING AIRPORT TAXI LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:MOHAMUD
Authorized Official - Middle Name:MOHAMED
Authorized Official - Last Name:MOHAMUD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:952-995-0110
Mailing Address - Street 1:9217 17TH AVE S STE 215
Mailing Address - Street 2:
Mailing Address - City:BLOOMINGTON
Mailing Address - State:MN
Mailing Address - Zip Code:55425-2372
Mailing Address - Country:US
Mailing Address - Phone:952-995-0110
Mailing Address - Fax:
Practice Address - Street 1:9217 17TH AVE S STE 215
Practice Address - Street 2:
Practice Address - City:BLOOMINGTON
Practice Address - State:MN
Practice Address - Zip Code:55425-2372
Practice Address - Country:US
Practice Address - Phone:952-995-0110
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-05-07
Last Update Date:2011-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN376242343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN376242OtherSTS