Provider Demographics
NPI:1619274917
Name:IKHLAS INTERNATIONAL COMPANY
Entity Type:Organization
Organization Name:IKHLAS INTERNATIONAL COMPANY
Other - Org Name:SAFE RIDE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:FARDOSA
Authorized Official - Middle Name:
Authorized Official - Last Name:KANYARE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:763-377-5733
Mailing Address - Street 1:12724 OWATONNA ST NE
Mailing Address - Street 2:
Mailing Address - City:BLAINE
Mailing Address - State:MN
Mailing Address - Zip Code:55449-4938
Mailing Address - Country:US
Mailing Address - Phone:763-377-5733
Mailing Address - Fax:
Practice Address - Street 1:12724 OWATONNA ST NE
Practice Address - Street 2:
Practice Address - City:BLAINE
Practice Address - State:MN
Practice Address - Zip Code:55449-4938
Practice Address - Country:US
Practice Address - Phone:763-377-5733
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-02-22
Last Update Date:2011-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNBY80595343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)