Provider Demographics
NPI:1447776554
Name:JUBBA TRANSPORTATION INC
Entity Type:Organization
Organization Name:JUBBA TRANSPORTATION INC
Other - Org Name:JUBBA TRANSPORTATION INC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:IBRAHIM
Authorized Official - Middle Name:S
Authorized Official - Last Name:ABDI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:320-282-0820
Mailing Address - Street 1:2719 W DIVISION ST STE 102
Mailing Address - Street 2:
Mailing Address - City:SAINT CLOUD
Mailing Address - State:MN
Mailing Address - Zip Code:56301-3420
Mailing Address - Country:US
Mailing Address - Phone:320-282-0820
Mailing Address - Fax:
Practice Address - Street 1:2719 W DIVISION ST STE 102
Practice Address - Street 2:
Practice Address - City:SAINT CLOUD
Practice Address - State:MN
Practice Address - Zip Code:56301-3420
Practice Address - Country:US
Practice Address - Phone:320-282-0820
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-08-21
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN495279799Medicaid