Provider Demographics
NPI:1598034548
Name:NEW VISION TRANSPORTATION L.L.C
Entity Type:Organization
Organization Name:NEW VISION TRANSPORTATION L.L.C
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER OR MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:EDAO
Authorized Official - Middle Name:HAWIYA
Authorized Official - Last Name:BUKULA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:651-354-1770
Mailing Address - Street 1:2441 YOUNGMAN AVE APT 2C
Mailing Address - Street 2:APT 2C
Mailing Address - City:SAINT PAUL
Mailing Address - State:MN
Mailing Address - Zip Code:55116-3043
Mailing Address - Country:US
Mailing Address - Phone:651-354-1770
Mailing Address - Fax:
Practice Address - Street 1:2441 YOUNGMAN AVE
Practice Address - Street 2:APT 2C
Practice Address - City:SAINT PAUL
Practice Address - State:MN
Practice Address - Zip Code:55116-3064
Practice Address - Country:US
Practice Address - Phone:651-354-1770
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-12-20
Last Update Date:2011-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN376376343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)