Provider Demographics
NPI:1134827082
Name:TOE, MONAH V (CEO)
Entity type:Individual
Prefix:
First Name:MONAH
Middle Name:V
Last Name:TOE
Suffix:
Gender:F
Credentials:CEO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5747 W BROADWAY AVE STE 212B
Mailing Address - Street 2:
Mailing Address - City:CRYSTAL
Mailing Address - State:MN
Mailing Address - Zip Code:55428-3881
Mailing Address - Country:US
Mailing Address - Phone:980-267-7003
Mailing Address - Fax:
Practice Address - Street 1:5747 W BROADWAY AVE STE 212B
Practice Address - Street 2:
Practice Address - City:CRYSTAL
Practice Address - State:MN
Practice Address - Zip Code:55428-3881
Practice Address - Country:US
Practice Address - Phone:980-267-7003
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-02-20
Last Update Date:2023-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN384401343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)