East Lakes Transport LLC

Primary specialty

Non-emergency Medical Transport (VAN)Taxonomy code 343900000X

Legal business name

EAST LAKES TRANSPORT LLC

Practice address

12325 4TH CT NE
Blaine, MN 55434-1989

Phone

(612) 735-1449

NPI assigned

May 16, 2025

Last updated

May 16, 2025By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Faiza Farah

Title

Manager

Phone

(612) 735-1449

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1747353600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1747353600000",
    "number": "1013708106",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12325 4TH CT NE",
            "city": "BLAINE",
            "state": "MN",
            "postal_code": "554341989"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12325 4TH CT NE",
            "city": "BLAINE",
            "state": "MN",
            "postal_code": "554341989",
            "telephone_number": "612-735-1449"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EAST LAKES TRANSPORT LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-05-16",
        "last_updated": "2025-05-16",
        "certification_date": "2025-05-16",
        "status": "A",
        "authorized_official_last_name": "FARAH",
        "authorized_official_first_name": "FAIZA",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "612-735-1449"
    },
    "taxonomies": [
        {
            "code": "343900000X",
            "taxonomy_group": "",
            "desc": "Non-emergency Medical Transport (VAN)",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Non-emergency Medical Transport (VAN) in Blaine, MN
• Providers in Blaine, MN by specialty
• Non-emergency Medical Transport (VAN) in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 16, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.