1518689751 NPI number — TIGIST OSMAN OBSE NONMEDICAL TRANSPORT

Table of content: TIGIST OSMAN OBSE NONMEDICAL TRANSPORT (NPI 1518689751)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1518689751 NPI number — TIGIST OSMAN OBSE NONMEDICAL TRANSPORT

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
OBSE
Provider First Name:
TIGIST
Provider Middle Name:
OSMAN
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
NONMEDICAL TRANSPORT
Provider Gender Code:
F

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:
1518689751
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
09/14/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1208 142ND ST E
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
ROSEMOUNT
Provider Business Mailing Address State Name:
MN
Provider Business Mailing Address Postal Code:
55068-2476
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
952-484-2484
Provider Business Mailing Address Fax Number:
952-885-6925

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
13919 ASHFORD PATH
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
ROSEMOUNT
Provider Business Practice Location Address State Name:
MN
Provider Business Practice Location Address Postal Code:
55068-3923
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
952-484-2484
Provider Business Practice Location Address Fax Number:
952-885-6925
Provider Enumeration Date:
09/14/2022

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 172A00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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