Provider Demographics
NPI:1932372364
Name:LBKY TRANSPORTATION SERVICES INC
Entity Type:Organization
Organization Name:LBKY TRANSPORTATION SERVICES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:MOJISOLA
Authorized Official - Middle Name:R
Authorized Official - Last Name:SIJUADE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:612-384-4511
Mailing Address - Street 1:9615 LINDEN LN N
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN PARK
Mailing Address - State:MN
Mailing Address - Zip Code:55443-1890
Mailing Address - Country:US
Mailing Address - Phone:612-384-4511
Mailing Address - Fax:763-657-0710
Practice Address - Street 1:9615 LINDEN LN N
Practice Address - Street 2:
Practice Address - City:BROOKLYN PARK
Practice Address - State:MN
Practice Address - Zip Code:55443-1890
Practice Address - Country:US
Practice Address - Phone:612-384-4511
Practice Address - Fax:763-657-0710
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-07
Last Update Date:2008-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN374187343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN275428100Medicaid