Organization
VICNIK TRANSPORTATION.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. VICTOR OLUSEGUN OGUNBANWO (OWNER)
(763) 568-6203
Entity
Organization
Contact information
Practice address
3701 66TH AVE N, BROOKLYN CENTER, MN 55429-1815
(763) 568-6203
(763) 780-7175
Mailing address
3701 66TH AVE N, BROOKLYN CENTER, MN 55429-1815
(763) 568-6203
(763) 780-7175
Taxonomy
Speciality
Code
Description
License number
State
343900000X
Non-emergency Medical Transport (VAN)
Primary
373258
MN
Other
Enumeration date
01/30/2008
Last updated
01/30/2008
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