Provider Demographics
NPI:1497126494
Name:WISE TRANSPORTATION
Entity Type:Organization
Organization Name:WISE TRANSPORTATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:ABDULKADIR
Authorized Official - Middle Name:M
Authorized Official - Last Name:ABDI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:612-229-7019
Mailing Address - Street 1:2219 OAKLAND AVE STE 104
Mailing Address - Street 2:
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55404-3749
Mailing Address - Country:US
Mailing Address - Phone:612-229-7019
Mailing Address - Fax:888-871-9886
Practice Address - Street 1:2219 OAKLAND AVE STE 104
Practice Address - Street 2:
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55404-3749
Practice Address - Country:US
Practice Address - Phone:612-229-7019
Practice Address - Fax:888-871-9886
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-10-15
Last Update Date:2015-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN=========Medicaid