Provider Demographics
NPI:1740646538
Name:BARAKA TRANSPORTATION
Entity type:Organization
Organization Name:BARAKA TRANSPORTATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:KHADRA
Authorized Official - Middle Name:
Authorized Official - Last Name:BARKHADLE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:651-703-8720
Mailing Address - Street 1:2719 W DIVISION ST STE 120
Mailing Address - Street 2:
Mailing Address - City:SAINT CLOUD
Mailing Address - State:MN
Mailing Address - Zip Code:56301-3822
Mailing Address - Country:US
Mailing Address - Phone:651-703-8720
Mailing Address - Fax:612-338-1493
Practice Address - Street 1:27 E FRANKLIN AVE
Practice Address - Street 2:
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55404-2518
Practice Address - Country:US
Practice Address - Phone:651-703-8720
Practice Address - Fax:612-338-1493
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-01-08
Last Update Date:2016-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343800000XTransportation ServicesSecured Medical Transport (VAN)