Provider Demographics
NPI:1285864108
Name:ROCHESTER SPECIAL TRANSPORTATION
Entity type:Organization
Organization Name:ROCHESTER SPECIAL TRANSPORTATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF OPERATIONS
Authorized Official - Prefix:MR
Authorized Official - First Name:AHMED
Authorized Official - Middle Name:HASSAN
Authorized Official - Last Name:OMAR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:507-202-6379
Mailing Address - Street 1:1312 1/2 7TH ST NW
Mailing Address - Street 2:200B
Mailing Address - City:ROCHESTER
Mailing Address - State:MN
Mailing Address - Zip Code:55901
Mailing Address - Country:US
Mailing Address - Phone:507-202-6379
Mailing Address - Fax:507-292-7964
Practice Address - Street 1:1312 1/2 7TH ST NW
Practice Address - Street 2:200
Practice Address - City:ROCHESTER
Practice Address - State:MN
Practice Address - Zip Code:55901
Practice Address - Country:US
Practice Address - Phone:507-202-6379
Practice Address - Fax:507-292-7964
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-07-27
Last Update Date:2009-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN343800000X343800000X
MN343900000X343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
No343800000XTransportation ServicesSecured Medical Transport (VAN)