Provider Demographics
NPI:1477928190
Name:SOUTHWEST TRANSPORTATION
Entity Type:Organization
Organization Name:SOUTHWEST TRANSPORTATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:OMAR
Authorized Official - Middle Name:M
Authorized Official - Last Name:ADOW
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:612-968-3902
Mailing Address - Street 1:1234 43 1/2 AVE NE
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA HEIGHTS
Mailing Address - State:MN
Mailing Address - Zip Code:55421-3021
Mailing Address - Country:US
Mailing Address - Phone:612-868-3902
Mailing Address - Fax:
Practice Address - Street 1:1234 43 1/2 AVE NE
Practice Address - Street 2:
Practice Address - City:COLUMBIA HEIGHTS
Practice Address - State:MN
Practice Address - Zip Code:55421-3021
Practice Address - Country:US
Practice Address - Phone:612-868-3902
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-12-07
Last Update Date:2015-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MND374074663414343900000X, 344600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
No344600000XTransportation ServicesTaxi