1093258733 NPI number — DODI TRANSPORTION LLC

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1093258733 NPI number — DODI TRANSPORTION LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
DODI TRANSPORTION LLC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1093258733
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
11/29/2016
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
3540 W SAINT GERMAIN ST
Provider Second Line Business Mailing Address:
SUITE 102
Provider Business Mailing Address City Name:
SAINT CLOUD
Provider Business Mailing Address State Name:
MN
Provider Business Mailing Address Postal Code:
56301-3795
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
320-282-3245
Provider Business Mailing Address Fax Number:
320-774-1008

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
3540 W SAINT GERMAIN ST
Provider Second Line Business Practice Location Address:
SUITE 102
Provider Business Practice Location Address City Name:
SAINT CLOUD
Provider Business Practice Location Address State Name:
MN
Provider Business Practice Location Address Postal Code:
56301-3795
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
320-282-3245
Provider Business Practice Location Address Fax Number:
320-774-1008
Provider Enumeration Date:
11/29/2016

Additional Information

Authorized Official

Authorized Official Last Name:
MURSAL
Authorized Official First Name:
MAHAD
Authorized Official Middle Name:
AHMED
Authorized Official Title or Position:
OWNER
Authorized Official Telephone Number:
320-282-3245

Provider Taxonomy Codes

  • Taxonomy code: 343900000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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