Metrodome Transportation LLC

Primary specialty

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

License

E475072735516 Issued in MN

Legal business name

METRODOME TRANSPORTATION LLC

Practice address

3057 14TH Ave S Apt 201
Minneapolis, MN 55407-1727

Phone

(612) 803-7072

NPI assigned

Jul 7, 2015

Last updated

Jul 7, 2015By 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

Faisal Derie

Title

Operations Manager

Phone

(612) 803-7072

Specialties & licenses 1

Addresses

Other names 1

• CEDAR TRANSPORTATION SERVICES LLC Former legal business name

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

{
    "created_epoch": "1436227200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1436227200000",
    "number": "1871976944",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3057 14TH AVE S APT 201",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554071727",
            "telephone_number": "612-803-7072"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3057 14TH AVE S APT 201",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554071727",
            "telephone_number": "612-803-7072"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "METRODOME TRANSPORTATION LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-07-07",
        "last_updated": "2015-07-07",
        "status": "A",
        "authorized_official_last_name": "DERIE",
        "authorized_official_first_name": "FAISAL",
        "authorized_official_title_or_position": "OPERATIONS MANAGER",
        "authorized_official_telephone_number": "612-803-7072"
    },
    "taxonomies": [
        {
            "code": "343900000X",
            "taxonomy_group": "",
            "desc": "Non-emergency Medical Transport (VAN)",
            "state": "MN",
            "license": "E475072735516",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CEDAR TRANSPORTATION SERVICES LLC",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

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• Non-emergency Medical Transport (VAN) in Minneapolis, MN
• Providers in Minneapolis, 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 Jul 7, 2015; 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.