Provider Demographics
NPI:1467279125
Name:BISITELLA TRANSPORTATION LLC
Entity type:Organization
Organization Name:BISITELLA TRANSPORTATION LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:IBRAHIM
Authorized Official - Middle Name:OLAYINKA
Authorized Official - Last Name:TELLA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:651-272-0045
Mailing Address - Street 1:2055 BRADLEY ST APT 204
Mailing Address - Street 2:
Mailing Address - City:MAPLEWOOD
Mailing Address - State:MN
Mailing Address - Zip Code:55117-2104
Mailing Address - Country:US
Mailing Address - Phone:651-283-7169
Mailing Address - Fax:
Practice Address - Street 1:2055 BRADLEY ST APT 204
Practice Address - Street 2:
Practice Address - City:MAPLEWOOD
Practice Address - State:MN
Practice Address - Zip Code:55117-2104
Practice Address - Country:US
Practice Address - Phone:651-283-7169
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-09-24
Last Update Date:2024-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)