Provider Demographics
NPI:1407577869
Name:ELFADIL BROTHERS LLC
Entity Type:Organization
Organization Name:ELFADIL BROTHERS LLC
Other - Org Name:MINNESOTA RIDES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:MAHMOUD
Authorized Official - Middle Name:
Authorized Official - Last Name:MOHAMED ELFADIL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:216-612-1943
Mailing Address - Street 1:722 LOST PINES LN
Mailing Address - Street 2:
Mailing Address - City:CEDAR PARK
Mailing Address - State:TX
Mailing Address - Zip Code:78613-7561
Mailing Address - Country:US
Mailing Address - Phone:216-612-1943
Mailing Address - Fax:
Practice Address - Street 1:5320 56TH ST NW APT 106
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:MN
Practice Address - Zip Code:55901-4455
Practice Address - Country:US
Practice Address - Phone:216-612-1943
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-09-05
Last Update Date:2022-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)