Provider Demographics
NPI:1619334935
Name:FARAYARE TRANSPORTATIONS LLC
Entity Type:Organization
Organization Name:FARAYARE TRANSPORTATIONS LLC
Other - Org Name:FARAYARE TRANSPORTATIONS LLC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ABDULLE
Authorized Official - Middle Name:AHMED
Authorized Official - Last Name:FARAYARE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:612-532-6172
Mailing Address - Street 1:774 CONCORDIA AVE
Mailing Address - Street 2:206
Mailing Address - City:SAINT PAUL
Mailing Address - State:MN
Mailing Address - Zip Code:55104-5500
Mailing Address - Country:US
Mailing Address - Phone:612-532-6172
Mailing Address - Fax:
Practice Address - Street 1:774 CONCORDIA AVE
Practice Address - Street 2:206
Practice Address - City:SAINT PAUL
Practice Address - State:MN
Practice Address - Zip Code:55104-5500
Practice Address - Country:US
Practice Address - Phone:612-532-6172
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-01-16
Last Update Date:2016-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN867296300038343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)