Provider Demographics
NPI:1336900778
Name:FAIRVIEW TRANSPORTATION
Entity Type:Organization
Organization Name:FAIRVIEW TRANSPORTATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRINCIPLE
Authorized Official - Prefix:
Authorized Official - First Name:ABDIRAHMAN
Authorized Official - Middle Name:S
Authorized Official - Last Name:ALI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:612-501-6672
Mailing Address - Street 1:12300 SINGLETREE LN APT 1201
Mailing Address - Street 2:
Mailing Address - City:EDEN PRAIRIE
Mailing Address - State:MN
Mailing Address - Zip Code:55344-7959
Mailing Address - Country:US
Mailing Address - Phone:612-501-6672
Mailing Address - Fax:
Practice Address - Street 1:12300 SINGLETREE LN APT 1201
Practice Address - Street 2:
Practice Address - City:EDEN PRAIRIE
Practice Address - State:MN
Practice Address - Zip Code:55344-7959
Practice Address - Country:US
Practice Address - Phone:612-501-6672
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-01-22
Last Update Date:2024-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)