Provider Demographics
NPI:1356722037
Name:SOUTHWEST HEALTH TRANSPORTAION
Entity type:Organization
Organization Name:SOUTHWEST HEALTH TRANSPORTAION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SHARMAKE
Authorized Official - Middle Name:
Authorized Official - Last Name:ALI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:952-288-9198
Mailing Address - Street 1:574 PRAIRIE CENTER DR
Mailing Address - Street 2:184
Mailing Address - City:EDEN PRAIRIE
Mailing Address - State:MN
Mailing Address - Zip Code:55344-7930
Mailing Address - Country:US
Mailing Address - Phone:952-288-9198
Mailing Address - Fax:612-234-4519
Practice Address - Street 1:574 PRAIRIE CENTER DR
Practice Address - Street 2:184
Practice Address - City:EDEN PRAIRIE
Practice Address - State:MN
Practice Address - Zip Code:55344-7930
Practice Address - Country:US
Practice Address - Phone:952-288-9198
Practice Address - Fax:612-234-4519
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-06-18
Last Update Date:2015-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)