Provider Demographics
NPI:1659107142
Name:S&J MEDICAL TRANSPORTATION LLC
Entity type:Organization
Organization Name:S&J MEDICAL TRANSPORTATION LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SIRAJ
Authorized Official - Middle Name:
Authorized Official - Last Name:ISSAK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:218-331-5544
Mailing Address - Street 1:2512 7TH AVE S STE 1
Mailing Address - Street 2:
Mailing Address - City:FARGO
Mailing Address - State:ND
Mailing Address - Zip Code:58103-8747
Mailing Address - Country:US
Mailing Address - Phone:218-331-5544
Mailing Address - Fax:
Practice Address - Street 1:2512 7TH AVE S STE 1
Practice Address - Street 2:
Practice Address - City:FARGO
Practice Address - State:ND
Practice Address - Zip Code:58103-8747
Practice Address - Country:US
Practice Address - Phone:218-331-5544
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-09-11
Last Update Date:2025-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)