Medibridge Transportation LLC

Primary specialty

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

Legal business name

MEDIBRIDGE TRANSPORTATION LLC

Practice address

5505 W 123Rd St Ste 104
Savage, MN 55378-5506

Phone

(952) 239-1717

NPI assigned

Nov 16, 2023

Organization subpart

No

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

Authorized official

Name

Issa M Omar

Title

Owner/Ceo

Phone

(952) 446-5484

Specialties & licenses 2

Addresses

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

{
    "created_epoch": "1700092800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1723507200000",
    "number": "1083489355",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5505 W 123RD ST STE 104",
            "city": "SAVAGE",
            "state": "MN",
            "postal_code": "553785506",
            "telephone_number": "952-239-1717"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5505 W 123RD ST STE 104",
            "city": "SAVAGE",
            "state": "MN",
            "postal_code": "553785506",
            "telephone_number": "952-239-1717"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1811 Northern Cedar Ave NW Apt 215",
            "address_purpose": "LOCATION",
            "city": "Bemidji",
            "state": "MN",
            "postal_code": "566012877",
            "country_code": "US",
            "telephone_number": "952-446-5484",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "MEDIBRIDGE TRANSPORTATION LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-11-16",
        "last_updated": "2024-08-13",
        "certification_date": "2024-08-13",
        "status": "A",
        "authorized_official_last_name": "OMAR",
        "authorized_official_first_name": "ISSA",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "OWNER/CEO",
        "authorized_official_telephone_number": "952-446-5484"
    },
    "taxonomies": [
        {
            "code": "343800000X",
            "taxonomy_group": "",
            "desc": "Secured Medical Transport (VAN)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "343900000X",
            "taxonomy_group": "",
            "desc": "Non-emergency Medical Transport (VAN)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Non-emergency Medical Transport (VAN) in Savage, MN
• Providers in Savage, 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 Aug 13, 2024; 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.