Provider Demographics
NPI:1578032850
Name:AXIS TRANSPORTATION LLC
Entity Type:Organization
Organization Name:AXIS TRANSPORTATION LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:SHAWNTIA
Authorized Official - Middle Name:GENEE
Authorized Official - Last Name:CHESTER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:763-670-5959
Mailing Address - Street 1:711 QUEEN AVE N
Mailing Address - Street 2:
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55411-3639
Mailing Address - Country:US
Mailing Address - Phone:763-670-5959
Mailing Address - Fax:612-588-7508
Practice Address - Street 1:711 QUEEN AVE N
Practice Address - Street 2:
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55411-3639
Practice Address - Country:US
Practice Address - Phone:763-670-5959
Practice Address - Fax:612-588-7508
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-11-16
Last Update Date:2018-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)