Provider Demographics
NPI:1396466819
Name:ADIL TAHA DBA HANNIBAL TRANSPORTATION
Entity type:Organization
Organization Name:ADIL TAHA DBA HANNIBAL TRANSPORTATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CONTRACTING AND COMPLIANCE
Authorized Official - Prefix:
Authorized Official - First Name:MOHAMMED
Authorized Official - Middle Name:
Authorized Official - Last Name:EL-BASHIR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:612-516-7803
Mailing Address - Street 1:14391 EDGEWOOD DR STE 209
Mailing Address - Street 2:
Mailing Address - City:BAXTER
Mailing Address - State:MN
Mailing Address - Zip Code:56425-8448
Mailing Address - Country:US
Mailing Address - Phone:612-516-7803
Mailing Address - Fax:218-216-8848
Practice Address - Street 1:14391 EDGEWOOD DRIVE
Practice Address - Street 2:SUITE 209
Practice Address - City:BAXTER
Practice Address - State:MN
Practice Address - Zip Code:56425-8448
Practice Address - Country:US
Practice Address - Phone:612-516-7803
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-09-05
Last Update Date:2022-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN383965OtherMN DOT