Provider Demographics
NPI:1629526629
Name:EAGLE TRANSPORTATION
Entity Type:Organization
Organization Name:EAGLE TRANSPORTATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/DRIVER
Authorized Official - Prefix:
Authorized Official - First Name:HALIMA
Authorized Official - Middle Name:H
Authorized Official - Last Name:JAMAL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:507-304-3658
Mailing Address - Street 1:630 N 4TH ST
Mailing Address - Street 2:
Mailing Address - City:MANKATO
Mailing Address - State:MN
Mailing Address - Zip Code:56001-3413
Mailing Address - Country:US
Mailing Address - Phone:507-304-3658
Mailing Address - Fax:
Practice Address - Street 1:630 N 4TH ST
Practice Address - Street 2:
Practice Address - City:MANKATO
Practice Address - State:MN
Practice Address - Zip Code:56001-3413
Practice Address - Country:US
Practice Address - Phone:507-304-3658
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-09-19
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN347C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes347C00000XTransportation ServicesPrivate Vehicle