Provider Demographics
NPI:1346561081
Name:MINNESOTA TRANSIT
Entity Type:Organization
Organization Name:MINNESOTA TRANSIT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:MR
Authorized Official - First Name:ANTON
Authorized Official - Middle Name:
Authorized Official - Last Name:KLOCHKO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:866-859-6160
Mailing Address - Street 1:15305 IODINE ST NW
Mailing Address - Street 2:
Mailing Address - City:RAMSEY
Mailing Address - State:MN
Mailing Address - Zip Code:55303-5719
Mailing Address - Country:US
Mailing Address - Phone:866-859-6160
Mailing Address - Fax:
Practice Address - Street 1:15305 IODINE ST NW
Practice Address - Street 2:
Practice Address - City:RAMSEY
Practice Address - State:MN
Practice Address - Zip Code:55303-5719
Practice Address - Country:US
Practice Address - Phone:866-859-6160
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-06-16
Last Update Date:2010-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN375739343900000X, 344600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
No344600000XTransportation ServicesTaxi