Organization
MIDWEST MOBILITY SERVICES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LEXINGTON MUTHAMA NDUULU PHD (ADMINISTRATOR)
(612) 363-4389
Entity
Organization
Contact information
Practice address
2645 1ST AVE S STE B01, MINNEAPOLIS, MN 55408-1806
(612) 767-7788
(612) 767-7789
Mailing address
2645 1ST AVE S STE B01, MINNEAPOLIS, MN 55408-1806
(612) 767-7788
(612) 767-7789
Taxonomy
Speciality
Code
Description
License number
State
343900000X
Non-emergency Medical Transport (VAN)
Primary
376132
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
376132
STS
MN
Enumeration date
04/12/2011
Last updated
04/12/2011
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