Provider Demographics
NPI:1417315870
Name:PHOENIXBIRD TRANSPORTATION INC
Entity Type:Organization
Organization Name:PHOENIXBIRD TRANSPORTATION INC
Other - Org Name:PHOENIXBIRD TRANSPORTATION INC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:FOWZIA
Authorized Official - Middle Name:MOHAMED
Authorized Official - Last Name:BIHI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:651-401-0020
Mailing Address - Street 1:12731 ABERDEEN ST NE
Mailing Address - Street 2:UNIT C
Mailing Address - City:BLAINE
Mailing Address - State:MN
Mailing Address - Zip Code:55449-4817
Mailing Address - Country:US
Mailing Address - Phone:651-401-0020
Mailing Address - Fax:612-205-1894
Practice Address - Street 1:12731 ABERDEEN ST NE
Practice Address - Street 2:UNIT C
Practice Address - City:BLAINE
Practice Address - State:MN
Practice Address - Zip Code:55449-4817
Practice Address - Country:US
Practice Address - Phone:651-401-0020
Practice Address - Fax:612-205-1894
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-02-01
Last Update Date:2016-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)