Provider Demographics
NPI:1659681500
Name:UNITED AIRPORT TRANSPORTATION
Entity Type:Organization
Organization Name:UNITED AIRPORT TRANSPORTATION
Other - Org Name:UNITED TAXI
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESDIENT
Authorized Official - Prefix:
Authorized Official - First Name:BENJAMIN
Authorized Official - Middle Name:OMAR
Authorized Official - Last Name:SHAMROKH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:612-791-0333
Mailing Address - Street 1:9217 17TH AVE S STE 124
Mailing Address - Street 2:
Mailing Address - City:BLOOMINGTON
Mailing Address - State:MN
Mailing Address - Zip Code:55425-2373
Mailing Address - Country:US
Mailing Address - Phone:612-703-5900
Mailing Address - Fax:952-406-8377
Practice Address - Street 1:9217 17TH AVE S STE 124
Practice Address - Street 2:
Practice Address - City:BLOOMINGTON
Practice Address - State:MN
Practice Address - Zip Code:55425-2373
Practice Address - Country:US
Practice Address - Phone:612-703-5900
Practice Address - Fax:952-406-8377
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-10-13
Last Update Date:2010-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)