Provider Demographics
NPI:1689016347
Name:SAHAN RESTUARANT
Entity Type:Organization
Organization Name:SAHAN RESTUARANT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:ABDIRAHIM
Authorized Official - Middle Name:
Authorized Official - Last Name:OMAR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:612-501-8299
Mailing Address - Street 1:912 E 24TH ST
Mailing Address - Street 2:
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55404-3869
Mailing Address - Country:US
Mailing Address - Phone:612-501-8299
Mailing Address - Fax:
Practice Address - Street 1:912 E 24TH ST
Practice Address - Street 2:
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55404-3869
Practice Address - Country:US
Practice Address - Phone:612-501-8299
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-07-23
Last Update Date:2013-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care